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Persistent Left Superior Vena Cava: Clinical Implications for Central Venous Cannulation
Author(s) -
Schummer Wolfram,
Schummer Claudia,
Hoffmann Eva,
Gerold Matthias
Publication year - 2002
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426502017005304
Subject(s) - medicine , persistent left superior vena cava , vena cava , surgery , cardiology , coronary sinus
In general, persistence of the left superior vena cava (LSVC), the most common anomaly of the venous circulation, is asymptomatic. Diagnosis of a catheter in a persistent LSVC is not straight forward, and a LSVC can create difficulties during central venous and pulmonary artery catheterization. We discuss the differential diagnosis of left‐sided central venous catheters (CVC). Finally a directive is given to prevent dilator‐induced vessel injuries. We report the cannulation of an unsuspected persistent LSVC in two patients. A dilator‐induced vessel injury contributed significantly to the fatal outcome in the first case. On a plain chest X‐ray, a catheter in a LSVC will run down the left mediastinal border and can be confused with other intravascular malpositions and extravascular malpositions. Contrast‐enhanced lateral chest radiograph is an inexpensive and readily available method that can be used to determine exact position.