An unusual complication of central line insertion: the left superior vena cava

A Vascath dialysis line was inserted under direct ultrasound guidance into the left internal jugular vein for plasmapharesis to treat a 60-year-old woman admitted with a myasthenic crisis secondary to sepsis. A chest X-ray was arranged to check the position of the line and look for any complications, which revealed the presence of a left superior vena cava. Because of the uncertainty of the drainage of this vein a right-sided catheter was then inserted. The repeat chest X-ray (Figure 1) shows both lines, and the two vena cava.