title: Persistent left superior vena cava detected after central venous catheter insertion.
abstract: BACKGROUND
  Persistent left superior vena cava is a rare case with an appearance of 0.3% to 0.5% of individuals in general population. Indication for jugular venous intervention could be different, such as implantable venous catheters for oncological therapy. The present report describes a case of a patient with a persistent left superior vena cava detected after central venous catheter (CVC) installation using computer-assisted tomography (CT).
  
  
  METHODS
  In a control chest X-ray the CVC was not in the right superior vena cava as expected to be. A following blood gas analysis revealed venous concentration. The consultation of additional CT diagnostics yielded a persistent left superior vena cava with an outlet to dilated coronary sinus.
  
  
  RESULTS
  The patient was followed over 1 year with the underlying disease of chronic obstructive pulmonary disease. Cardiac insufficiency, sinus aneurysm and arryhtmias could appear with growing age in patients with persistence left superior vena cava, but most of them are asymptomatic. Knowing the venous anatomy is important for correct position and function of e.g. totally implantable venous catheters, central lines or pacemakers.
  
  
  CONCLUSIONS
  The importance of early imaging diagnosis of this anatomical variation could optimize adequate therapy and finally improve living conditions. CT can help adapting correct therapy with correct diagnostics.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany ; German Center for Cardiovascular Research, DZHK, Göttingen, Germany ; Institute for Diagnostic and Interventional Radiology, Center of Radiology, DZHK, Georg-August-University Göttingen, UMG Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Sohns
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany ; German Center for Cardiovascular Research, DZHK, Göttingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Fasshauer
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany ; German Center for Cardiovascular Research, DZHK, Göttingen, Germany.
authors.forename: Wieland
authors.initials: W
authors.lastname: Staab
authors.affiliation: German Center for Cardiovascular Research, DZHK, Göttingen, Germany ; Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August-University, Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Steinmetz
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany ; German Center for Cardiovascular Research, DZHK, Göttingen, Germany ; Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Unterberg-Buchwald
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany ; German Center for Cardiovascular Research, DZHK, Göttingen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Menke
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany ; German Center for Cardiovascular Research, DZHK, Göttingen, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Lotz
keywords: Cardiac CT; Chest x-ray; Coronary sinus; Persistent left superior vena cava; Vena cava; Venous catheter installation