Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization
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 schedul...
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Korean Society of Critical Care Medicine
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doaj-4641240834f1446a8fcc6e04b2a05c8c2020-11-24T22:24:37ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-4870301222610.4266/kjccm.2015.30.1.2293Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery CatheterizationHyun Jeong Lee0Namo Kim1Hyelin Lee2Jae Kwang Shim3Jong Wook Song4Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, KoreaWe 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.http://www.kjccm.org/upload/pdf/kjccm-2015-30-1-22.pdfcatheterization, Swan-Ganzvascular malformationsvena cava, superior |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hyun Jeong Lee Namo Kim Hyelin Lee Jae Kwang Shim Jong Wook Song |
spellingShingle |
Hyun Jeong Lee Namo Kim Hyelin Lee Jae Kwang Shim Jong Wook Song Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization Korean Journal of Critical Care Medicine catheterization, Swan-Ganz vascular malformations vena cava, superior |
author_facet |
Hyun Jeong Lee Namo Kim Hyelin Lee Jae Kwang Shim Jong Wook Song |
author_sort |
Hyun Jeong Lee |
title |
Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization |
title_short |
Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization |
title_full |
Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization |
title_fullStr |
Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization |
title_full_unstemmed |
Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization |
title_sort |
persistent left superior vena cava detected incidentally after pulmonary artery catheterization |
publisher |
Korean Society of Critical Care Medicine |
series |
Korean Journal of Critical Care Medicine |
issn |
2383-4870 |
description |
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. |
topic |
catheterization, Swan-Ganz vascular malformations vena cava, superior |
url |
http://www.kjccm.org/upload/pdf/kjccm-2015-30-1-22.pdf |
work_keys_str_mv |
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1725760480930168832 |