Persistent left superior vena cava and central venous catheter position: clinical impact illustrated by four cases

Schummer, Wolfram; Schummer, Claudia; Fröber, Rosemarie

doi:10.1007/s00276-003-0138-6

Cited by 96 publications

(84 citation statements)

References 21 publications

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“…Although normal anatomy and its radiological appearance represents core knowledge, not every clinician is aware of the variations of the SVC. This abnormality has been well documented previously in patients with (Cha and Khoury, 1972) and without congenital heart disease (Schummer et al, 2003).…”

Section: Introductionmentioning

confidence: 72%

Case of double superior vena cava

et al. 2005

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A 23-year-old male patient who had no history of any previous medical illness was noted to have a widened mediastinum on chest X-ray undertaken as part of a routine medical evaluation. A computer tomographic (CT) scan confirmed the widened mediastinum to be due to a double superior vena cava (SVC). No further investigations were undertaken. The patient was noted to be well when re-assessed 3 years later.

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Section: Introductionmentioning

confidence: 72%

Case of double superior vena cava

et al. 2005

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“…7) Catheter tip manipulation in the coronary sinus may cause serious complications such as shock, cardiac arrest, and angina in adults with a PLSVC. 5) Central venous stenosis or occlusion is a common complication that leads to access dysfunction in HD patients. Endovascular treatment for central venous stenosis or occlusion is well-known as a safe and effective procedure in HD patients.…”

Section: Discussionmentioning

confidence: 99%

“…4) Serious complications such as shock, angina and cardiac arrest have been described during catheterization in adults with a PLSVC. 5,6) Recently, we encountered a recurrent left subclavian venous stenosis in an HD patient with a PLSVC. We performed endovascular stent placement safely and effectively for the stenosis employing the pull-through technique from the left internal jugular vein to the access vein.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Stenting for Left Subclavian Venous Stenosis for a Hemodialysis Patient with a Persistent Left Superior Vena Cava

Matsumoto

Yamagami

Morishita

et al. 2012

Annals of Vascular Diseases

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A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly, and we should be aware of its existence. We encountered a case of significant left arm swelling due to recurrent left subclavian venous stenosis in a hemodialysis patient with a PLSVC. Endovascular stent placement was performed safely and effectively for the stenosis employing the pull-through technique, in which a guidewire was passed from the left internal jugular vein to the access vein. On the following day, left arm swelling had improved. 3 months after stent placement the left arm swelling has not recurred.

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“…According to Schummer, the superior vena cava system can be classified as type I, normal anatomy; type II, only LPSVC; type IIIa, right and left superior vena cava with connection; and type IIIb, right and left superior vena cava without connection [18,19]. The most frequent variant (82%) of the normal anatomy is the simultaneous presence of both right and left cava veins (double superior vena cava, type III) and so this anomaly is often missed as central line catheters are more commonly inserted on the right side [20,21].…”

Section: Commentmentioning

confidence: 99%

The Role of 3-Dimensional Ultrasound for the Diagnosis of LPSVC and A Review of the Literature

Ellithyb¹

2014

Gynecol Obstet(sunnyvale)

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Objective: The purpose of this article is to review the published literature and determine the rolethat3-dimensional Ultrasonography (3DUS) play in the diagnosis of LPSVC. Methods:The volume data sets were acquired with transverse sweeps through the fetal chest. Volumes were stored in the ultrasound machine's hard drive and subsequently analyzed offline.Results: PLSVC was unequivocally diagnosed and the diagnosis confirmed by postnatal US.Conclusion: 3D ultrasonography especially power Doppler imaging made it possible to unequivocally confirm the diagnosis of the LPSVC and demonstrate LPSVC entering the dilated coronary sinus. The images obtained made it easy to explain this anomaly to the patient. This case of isolated LPSVC in a 30 -week fetus demonstrates the added value of 3D ultrasonography and especially 3D power colour in fetal echocardiography. Case PresentationA 39-year-old woman, gravida 2 para 1, presented at 30 weeks' gestation for detailed targeted organ scanning with fetal echocardiography, after having received contradictory opinions concerning a suspected atrioventricular canal defect during previous ultrasound examinations. Karyotype, which had been tested because of advanced maternal age, was normal. Targeted organ scanning for exclusion of fetal anomalies was performed, including complete fetal echocardiography 2 and 3 D US and coulor Doppler and 3 D Power Doppler power imaging (Figures 1-3).In the present case, the initial diagnosis of LPSVC was made on observation of a dilated coronary sinus and an extraneous vessel identified to the left of the ductal arch in the three-vessels and trachea (3VT) view of the fetal heart ( Figures 1E ,F and 3D).We performed ultrasound examinations using a GE Voluson 730 pro. (Voluson 730, GE Healthcare, Milwaukee, WI, USA) using a 3-5-MHz mechanical volume transabdominal transducer). The volumes were stored and subsequently analyzed offline.Meticulous inspection of the fetal anatomy did not reveal any associated cardiac or extra cardiac anomalies and fetal growth was on the 50th centile. A male neonate was spontaneously delivered at38 weeks of gestation with a birth weight of 3150 g with Apgar scores of 8, 9 and 10 at 1,5 and 10 min, respectively. Postnatal adaptation was uneventful. Postnatal echocardiography confirmed the prenatal diagnosis.3D power Doppler imaging made it possible to unequivocally confirm the diagnosis of the LPSVC and demonstrate LPSVC entering the dilated coronary sinus (Figures 1 and 3). The images obtained made it easy to explain this anomaly to the patient. This case of isolated LPSVC in a 30-week fetus demonstrates the added value of power colour Doppler 3D in fetal echocardiography.It appears that 3Dpower Doppler imaging applications will make a significant contribution to our understanding of the developing fetal heart in both normal and anomalous cases, to interdisciplinary management team consultation, to parental counselling, and to professional training CommentPersistent left superior vena cava is a rare but is the most...

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Persistent left superior vena cava and central venous catheter position: clinical impact illustrated by four cases

Cited by 96 publications

References 21 publications

Case of double superior vena cava

Case of double superior vena cava

Endovascular Stenting for Left Subclavian Venous Stenosis for a Hemodialysis Patient with a Persistent Left Superior Vena Cava

The Role of 3-Dimensional Ultrasound for the Diagnosis of LPSVC and A Review of the Literature

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