Persistent Left Superior Vena Cava: An Intensivist's Experience and Review of the Literature

Rajit Pahwa, MD, Anand Kumar, MD

Disclosures

South Med J. 2003;96(5) 

In This Article

Case Report

A 56-year-old woman presented with pneumonia, septic shock, and acute renal failure. A dialysis catheter was placed via the right subclavian vein. The left internal jugular vein was used for the placement of a balloon-tipped PA catheter; placement was uneventful. A chest x-ray obtained subsequently revealed the passage of the PA catheter through the LSVC into the right atrium (Fig. 1). The thoracic computed tomography (CT) scan withcontrast (obtained after removal of the PA catheter) showed the dialysis catheter in the normal right superior vena cava (intravascular opacity; Fig. 2) and the persistent LSVC (arrow; Fig. 2, A-C) as it drains into the right atrium (arrow; Fig. 2D) after joining the coronary sinus. The PA catheter was maintained in position for 3 days without complications.

X-ray showing the right subclavian dialysis catheter with a normal course in the right atrium and the left pulmonary artery catheter via internal jugular vein passing through a persistent left superior vena cava into the right atrium where it forms a loop, leading into the right ventricle and then into the pulmonary artery.

Thoracic computed tomographic scan with contrast showing dialysis catheter in the normal superior vena cava (intravascular opacity) and the persistent left superior vena cava (arrows in A-C) as it drains into the right atrium (arrow in D) after joining the coronary sinus.

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