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Related Experiment Videos

Peripherally inserted central catheter malposition in a persistent left superior vena cava.

Patricia A Kamola1, Douglas L Seidner

  • 1The Cleveland Clinic Foundation, Cleveland Ohio 44195, USA.

Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society
|May 1, 2004
PubMed
Summary

Persistent left superior vena cava (PLSVC) is a common congenital anomaly. This case highlights PLSVC diagnosis during central venous catheter placement, revealing a malpositioned catheter within the anomalous vessel.

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Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Congenital Anomalies

Background:

  • Persistent left superior vena cava (PLSVC) is the most common anomaly of the superior vena cava system.
  • This vessel normally degenerates during embryonic development; failure results in PLSVC.
  • PLSVC is often asymptomatic if not associated with other cardiac defects.

Observation:

  • A case involving difficulties in peripherally inserted central venous catheter (PICC) placement is presented.
  • Two PICCs appeared malpositioned outside the central circulation during bedside attempts.
  • Referral to interventional radiology was necessary for Hickman catheter placement.

Findings:

  • A contrast study confirmed the presence of PLSVC.
  • The normal right superior vena cava was absent.

Related Experiment Videos

  • The PICC tip was satisfactorily positioned within the PLSVC.

    • Implications:

    • This case underscores the importance of recognizing PLSVC during central venous access procedures.
    • Accurate diagnosis through imaging is crucial for safe catheter placement.
    • Understanding PLSVC anatomy aids in managing patients requiring central venous access.