title: [Diagnosis of persistent left superior vena cava in a child using transesophageal echocardiography].
abstract: An 11-year-old boy with X-linked alpha-thalassaemia/ mental retardation symptom underwent gastrostomy. After the surgical procedure, insertion of a central venous (CV) catheter via the left subclavian vein was performed under X-ray radioscopy. However, the catheter did not move toward the right side of the heart shadow but descended caudally through the left side of the heart shadow. Transesophageal echocardiography (TEE) showed thickening of the coronary sinus, suggesting the existence of a persistent left superior vena cava (PLSVC). Contrast echocardiography using infusion of agitated saline into the CV catheter was performed. Microbubbles flowing from the coronary sinus into the right atrium were observed, and a diagnosis of PLSVC was made. TEE is useful for diagnosis of PLSVC when passage of a CV catheter via the left subclavian vein or left internal jugular vein is incorrect in a pediatric patient.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, Asahikawa 078-8510.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Toyama
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kunisawa
authors.forename: Michio
authors.initials: M
authors.lastname: Nagashima
authors.forename: Hanako
authors.initials: H
authors.lastname: Okada
authors.forename: Akihiro
authors.initials: A
authors.lastname: Suzuki
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
mesh_terms: D002405:Catheterization, Central Venous; D002648:Child; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008607:Intellectual Disability; D013350:Subclavian Vein; D013577:Syndrome; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D017085:alpha-Thalassemia