Key result
A persistent left superior vena cava with an outlet to a dilated coronary sinus and absence of a right superior vena cava was incidentally detected by CT after central venous catheter insertion.
Case Report (n=1)
CT imaging is crucial for identifying rare venous anomalies like persistent left superior vena cava to ensure correct placement and function of central venous catheters.
Highlights need for anomaly awareness during central access; case report leaves open systematic CT evaluation.
INTRODUCTION: 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). CASE DESCRIPTION: 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. DISCUSSION AND EVALUATION: 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. CONCLUSION: 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.
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Sohns et al. (2014) conducted a case report in Persistent left superior vena cava (n=1). Central venous catheter insertion and CT imaging was evaluated on Detection of persistent left superior vena cava. A persistent left superior vena cava with an outlet to a dilated coronary sinus and absence of a right superior vena cava was incidentally detected by CT after central venous catheter insertion.
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