[Placement of a central venous catheter in cases of persistent left superior vena cava]

Area of Science:

• Cardiology
• Vascular Surgery
• Medical Case Reports

Background:

• Persistent left superior vena cava (PLSVC) is a rare congenital anomaly where the left superior vena cava does not regress during embryonic development.
• While often asymptomatic, PLSVC can present significant risks during central venous catheter (CVC) placement.
• PLSVC is frequently associated with congenital heart defects but can occur in otherwise healthy individuals.

Observation:

• This case report details the CVC placement in a patient with an undiagnosed PLSVC.
• The potential for vascular perforation and pulmonary injury during CVC insertion in the presence of PLSVC was noted.

Findings:

• Undiagnosed PLSVC can lead to serious complications during CVC procedures.
• Standard anatomical knowledge may not suffice, necessitating heightened vigilance during CVC insertion.

Implications:

• Clinicians should consider the possibility of PLSVC in all patients undergoing CVC placement, regardless of cardiac history.
• Enhanced imaging or careful technique may be required to mitigate risks associated with PLSVC during CVC procedures.
• This case underscores the importance of recognizing and managing rare vascular anomalies in routine medical interventions.