Key result
Hemodialysis catheterization through a persistent left superior vena cava is feasible and can provide adequate blood flow for dialysis, provided the vessel drains into the right atrium with sufficient diameter.
Why the study?
Whether hemodialysis catheters can be placed in persistent left superior vena cava remains controversial.
Case Report (n=29)
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PLSVC can serve as an alternative site for conventional dialysis access if it drains into the right atrium with sufficient inner diameter and blood flow, though careful preoperative assessment is required to avoid severe complications.
BACKGROUND: Persistent left superior vena cava (PLSVC) is a common vena cava malformation, and drains blood into the right atrium via the dilated coronary sinus in most cases. It is usually asymptomatic and detected incidentally during invasive procedures or imaging. Whether the hemodialysis catheters can be placed in PLSVC is still controversial now (Stylianou et al. Hemodial Int 11:42-45, 2007). CASE PRESENTATION: Here we report a rare case of catheterization through PLSVC in an end-stage renal disease (ESRD) male patient whose PLSVC connected with pulmonary vein with insufficient blood flow eventually. Among the other 28 cases included in the literature review, 16 cases were non-tunneled catheter and 12 cases were cuffed, tunneled catheter and most of them could provide adequate blood flow. CONCLUSION: PLSVC is a rare malformation and mostly asymptotic, we believe that PLSVC drains blood into the right atrium with enough inner diameter and blood flow can serve as an alternative site for conventional dialysis access. However, the feasibility of hemodialysis catheterization through it and measures to avoid serious complications are still needed to be discussed.
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He et al. (2019) conducted a case report in End-stage renal disease (ESRD) with persistent left superior vena cava (PLSVC) (n=29). Hemodialysis catheterization through persistent left superior vena cava was evaluated on Feasibility and adequacy of blood flow for hemodialysis. Hemodialysis catheterization through a persistent left superior vena cava is feasible and can provide adequate blood flow for dialysis, provided the vessel drains into the right atrium with sufficient diameter.
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