Persistent Left Superior Vena Cava Suggested by an Unusual Central Venous Pressure Waveform.

Sujana Dontukurthy,Yoshikazu Yamaguchi,Joseph D Tobias

doi:10.1055/s-0040-1708474

Abstract

Background A persistent left superior vena cava (PLSVC) is the most common congenital anomaly of the thoracic venous return. Case Description During atrial septal defect repair, a pulmonary artery (PA) catheter was placed via the left internal jugular vein. Although placement of the PA catheter in the main PA was confirmed by transesophageal echocardiography, the central venous pressure (CVP) waveform was abnormal. Intraoperatively, the PA catheter was seen exiting the coronary sinus with the CVP port within the coronary sinus. Conclusions The diagnosis of PLSVC is discussed and the differential diagnosis of the abnormal “ventricular” pattern of the CVP waveform is reviewed.

Highlights

It is the most common congenital anomaly of the thoracic venous return, a persistent left superior vena cava (PLSVC) has a reported incidence of less than 0.5% in the general population.[1,2,3,4] The incidence is higher (10–12%) in association with other forms of congenital heart disease, most commonly atrial (ASD) and ventricular septal defects
Case Description During atrial septal defect repair, a pulmonary artery (PA) catheter was placed via the left internal jugular vein
Placement of the PA catheter in the main PA was confirmed by transesophageal echocardiography, the central venous pressure (CVP) waveform was abnormal

Summary

Background

A persistent left superior vena cava (PLSVC) is the most common congenital anomaly of the thoracic venous return. Case Description During atrial septal defect repair, a pulmonary artery (PA) catheter was placed via the left internal jugular vein. Placement of the PA catheter in the main PA was confirmed by transesophageal echocardiography, the central venous pressure (CVP) waveform was abnormal. The PA catheter was seen exiting the coronary sinus with the CVP port within the coronary sinus

Introduction

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Discussion