Peripherally inserted central catheter malposition in a persistent left superior vena cava.
Persistent left superior vena cava (PLSVC) is the most common congenital anomaly of the superior vena cava system. Left superior vena cava exists in early embryonic development, but this vessel degenerates as the cardiovascular system matures. Failure of this process to occur results in PLSVC. If not associated with other cardiac malformations, PLSVC has no clinical signs or symptoms. This article discusses a case of PLSVC diagnosed after placement of two peripherally inserted central venous catheters that appeared to malposition outside the central circulation. After unsuccessful bedside placement of the two catheters, the patient was referred to interventional radiology for placement of a Hickman catheter. A contrast injection study showed the presence of a PLSVC with the absence of a normal right superior vena cava. The tip of the peripherally inserted central venous catheter was found to be at a satisfactory location within the PLSVC.
Kamola
Patricia A
PA
The Cleveland Clinic Foundation, Cleveland Ohio 44195, USA.
Seidner
Douglas L
DL
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D002481:Cellulitis / Q000188:drug therapy; D006801:Humans; D008297:Male; D011859:Radiography; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging
D000900:Anti-Bacterial Agents