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Can a left internal jugular catheter be used in the hemodialysis of a patient with persistent left superior vena cava?
Author(s) -
STYLIANOU Konstantinos,
KORSAVAS Konstantinos,
VOLOUDAKI Argyro,
PATRIANAKOS Alexandros,
VARDAKI Eleftheria,
TZENAKIS Nikolaos,
DAPHNIS Eugene
Publication year - 2007
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2007.00152.x
Subject(s) - medicine , persistent left superior vena cava , coronary sinus , catheter , sinus venosus , left pulmonary vein , cardiology , superior vena cava , lumen (anatomy) , radiology , thrombosis , internal jugular vein , embolization , cardiac catheterization , surgery , atrial fibrillation , pulmonary vein
A patient with a persistent left superior vena cava (PLSVC) was incidentally diagnosed after positioning of a dual lumen catheter for hemodialysis into the left internal jugular vein. Although PLSVC is a relatively rare condition, it is the most common congenital anomaly of thoracic venous circulation. It represents the persistence of the left horn of the embryonic sinus venosus, which normally involutes during embryogenesis to become the coronary sinus. The existence of a PLSVC can cause a significant diagnostic dilemma during catheterization of the left internal jugular vein, pertaining to the positioning of the catheter. It may also be associated with significant clinical implications such as systemic embolization, provocation of arrhythmia, and thrombosis of the vessel. The safety of such catheterization has not been adequately evaluated due to the rarity of this condition. We believe that a diagnostic workup including blood gas analysis, echocardiography, and computed tomography is necessary to confirm a right atrial drainage and a patent innominate vein as prerequisites to maintain the catheter in position.