Diagnosis of a left-sided superior vena cava during placement of a pulmonary artery catheter

Sweitzer, Bobbie Jean; Hoffman, William J.; Allyn, John; Daggett, Willard J.

doi:10.1016/0952-8180(93)90070-u

Cited by 17 publications

(9 citation statements)

References 16 publications

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“…The PLSVC may go unnoticed, as a right-sided SVC typically coexists with a PLSVC, and central venous catheters are more commonly placed in the right internal jugular vein. It is generally discovered incidentally during central venous catheterization, pacemaker electrode placement, cardiopulmonary bypass surgery, or during evaluation for cardiac rhythm disturbance (8)(9)(10)(11)(12)(13)(14).…”

Section: Clinical Implications and Diagnosismentioning

confidence: 99%

ASDM Clinical Case Focus: Persistent Left Superior Vena Cava: Diagnosis and Implications for the Interventional Nephrologist

Wasse

2006

Seminars in Dialysis

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Awareness and recognition of anatomic anomalies of the great vessels of the neck and chest are important for the interventional nephrologist, as central venous catheter placement is a common procedure. A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly (0.3-0.5% of the population), and can present difficulty during internal jugular or subclavian vein catheter insertion, as well as pose a diagnostic dilemma. In this report, two cases of PLSVC are described, and the clinical significance and diagnosis of PLSVC are reviewed.

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Section: Clinical Implications and Diagnosismentioning

confidence: 99%

ASDM Clinical Case Focus: Persistent Left Superior Vena Cava: Diagnosis and Implications for the Interventional Nephrologist

Wasse

2006

Seminars in Dialysis

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“…It is reported with an incidence of about 0.3% to 0.5%. [7][8][9][10] For further reading, we recommend articles by Edwards, Oczenski et al, or Sweitzer et al [11][12][13] LSVC does not provoke symptoms or other clini-cal signs except in rare instances of direct drainage LSVC into the left atrium. The main problems in these patients are technical and occur when an attempt is made to introduce a catheter through the narrow opening of the coronary sinus to reach the right atrium.…”

Section: Embryology and Anatomymentioning

confidence: 99%

Persistent Left Superior Vena Cava: Clinical Implications for Central Venous Cannulation

Schummer

Schummer²,

Hoffmann

et al. 2002

Nut in Clin Prac

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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.

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“…3-5% der Bevölkerung mit kongenitalen Herzerkrankungen [9]. 0,5% der Normalbevölkerung [2, 10] jedoch in ca.…”

Section: Diskussionunclassified

“…Von Seiten der Anästhesie ist zu bedenken, daß die Positionierung eines Pulmonalarterienkatheters oder eines intravenös einzuschwemmenden Schrittmachers über die linke V. jugularis interna oder linke V. subclavia bei einer PLSVC deutlich erschwert sein kann [9]. Eine Röntgenthoraxaufnahme zur echokardiographisch ein erster Hinweis auf eine PLSVC sein.…”

Section: Diskussionunclassified

Koronarsinusdilatation

et al. 2000

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A 36-year old woman was presented to our hospital with congenital ventricular septal defect and one-vessel coronary artery disease (75% proximal left main coronary artery) for CABG and repair of the VSD. After induction, a transesophageal echocardiographic (TEE) baseline examination was performed, showing a severely dilated coronary sinus (CS) measuring approximately 3 cm (abnormal >1 cm). We suggested a persistent left superior vena cava (PLSVC) draining into the CS. PLSVC is a common venous congenital anomaly, with a reported incidence of 0.5% in general population and in 3-5 % of patients with congenital heart defect. Injection of echo-contrast solution in a left arm vein, visualizing microbubbles passing through the PLSVC into the CS confirmed our suspicion. The diagnosis of a PLSVC and dilated CS is a contraindication for retrograde cardioplegia because of the loss of cardioplegia into the PLSVC resulting in a inadequate myocardial protection. It may be difficult to pass a pulmonary artery catheter (PAC) through a left internal or left subclavian vein and it may be associated with arrhythmias. A chest radiograph shows the anomalous course of the PAC along the left heart.

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Diagnosis of a left-sided superior vena cava during placement of a pulmonary artery catheter

Cited by 17 publications

References 16 publications

ASDM Clinical Case Focus: Persistent Left Superior Vena Cava: Diagnosis and Implications for the Interventional Nephrologist

ASDM Clinical Case Focus: Persistent Left Superior Vena Cava: Diagnosis and Implications for the Interventional Nephrologist

Persistent Left Superior Vena Cava: Clinical Implications for Central Venous Cannulation

Koronarsinusdilatation

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