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Partial Anomalous Pulmonary Venous Return Diagnosed by Central Catheter Misplacement
Lena Reichert1, Ioannis Bougioukas1, Ralf Seipelt1
1Department of Cardiothoracic Surgery, SHG-Kliniken Voelklingen, Voelklingen, Germany.
The Thoracic and Cardiovascular Surgeon Reports
|September 25, 2020
Summary
An abnormal connection in the left lung
Area of Science:
- Cardiology
- Thoracic Surgery
- Radiology
Background:
- Anomalous pulmonary venous connections (APVCs) involve abnormal drainage of left lung veins, often into the innominate vein.
- These anomalies can affect all or part of the left lung's venous drainage.
Observation:
- A patient undergoing coronary bypass surgery had central lines placed via internal jugular veins.
- Blood gas analysis from these lines indicated a left-to-right shunt.
- Computed tomography (CT) confirmed a pulmonary venous anomaly, with a misplaced catheter in an abnormal vein.
Findings:
- The case highlights a rare instance of APVC.
- Misinterpretation of central venous catheter readings can occur with APVC.
- CT imaging is crucial for diagnosing such anomalies.
Implications:
- Clinicians should consider APVC when blood gas analysis suggests shunting during central line placement.
- Measuring mean pressure through central catheters can aid in suspicion.
- Early diagnosis of pulmonary venous anomalies prevents potential complications.
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