title: [Unusual course of a pulmonary artery catheter through a  persistent superior vena cava]  .
abstract: We report the unusual course of a pulmonary artery catheter through a persistent left-sided superior vena cava. After left subclavian vein cannulation and downward left-sided paramediastinum course, the Swan-Ganz catheter enters the right pulmonary artery. Haemodynamic monitoring was consistent with the diagnosis of septic shock developed by this 56-year-old woman, after cephalic duodenopancreatectomy. Persistent left-sided superior vena cava occurs in 0.5% of the population and 5-10% of patients with congenital heart diseases. It drains into the right atrium through the coronary sinus in 92% of cases and is associated with an absent right superior vena cava in 20% of cases. The left-sided superior vena cava persists when the caudal part of the left anterior cardinal vein does not degenerate. A persistent left superior vena cava may be medically relevant during implantation of pacemaker leads or radiofrequency ablation, during cardiac surgery for placement of a retrograde coronary sinus cardioplegia catheter and during transjugular intrahepatic portosystemic shunt placement.
authors.affiliation: Département d'anesthésie-réanimation et urgences, HIA Clermont-Tonnerre, rue du Colonel Fonferrier, BP 41, 29240 Brest-Naval, France.
authors.forename: M
authors.initials: M
authors.lastname: Ould-Ahmed
authors.forename: B
authors.initials: B
authors.lastname: Mas
authors.forename: E
authors.initials: E
authors.lastname: Hautbois
authors.forename: J F
authors.initials: JF
authors.lastname: Garcia
authors.forename: P
authors.initials: P
authors.lastname: Caroff
authors.forename: M
authors.initials: M
authors.lastname: Guiavarch
mesh_terms: D000792:Angiography; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging
vernacular_title: Pseudo-fausse route d'un cathéter artériel pulmonaire via une veine cave supérieure gauche.