Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization.
10.4266/kjccm.2015.30.1.22
- Author:
Hyun Jeong LEE
;
Namo KIM
;
Hyelin LEE
;
Jae Kwang SHIM
;
Jong Wook SONG
- Publication Type:Case Report
- Keywords:
catheterization, Swan-Ganz;
vascular malformations;
vena cava, superior
- MeSH:
Arterial Pressure;
Catheterization, Swan-Ganz*;
Catheters;
Coronary Sinus;
Echocardiography;
Echocardiography, Transesophageal;
Heart Ventricles;
Humans;
Jugular Veins;
Male;
Middle Aged;
Mitral Valve;
Pulmonary Artery;
Sternotomy;
Vascular Malformations;
Veins;
Vena Cava, Superior*
- From:Korean Journal of Critical Care Medicine
2015;30(1):22-26
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present a case of pulmonary artery catheter (PAC) placement through the right internal jugular vein, bridging vein and coronary sinus in a patient with previously unrecognized persistent left superior vena cava (LSVC) and diminutive right superior vena cava. A 61-year-old male patient was scheduled for mitral valve repair for regurgitation. Preoperative transthoracic echocardiography revealed dilated coronary sinus, but no further evaluations were performed. During advancement of the PAC, right ventricular and pulmonary arterial pressure tracing was observed at 50 and 60 cm, respectively. Transesophageal echocardiography ruled out intracardiac knotting and revealed the presence of the PAC in the LSVC, entering the right ventricle from the coronary sinus. Diminutive right superior vena cava was observed after sternotomy. The PAC was left in place for 2 days postoperatively without any complications. This case emphasizes that the possibility of LSVC and associated anomalies should always be ruled out in patients with dilated coronary sinus.
