Where is the central line?

摘要

Persistent left superior vena cava is an uncommon anatomical variation. It is usually hidden until procedures requiring left side approach to the central circulation are necessary. Although is the most common thoracic venous vascular anatomical variation limited medical personnel in training are aware of it. We report a case of left superior vena cava after left internal jugular catheterization. Case Presentation A 36-year-old male was admitted to the intensive care unit due to altered mental status, sepsis, acute renal failure. The internal jugular vein was canalized after unsuccessfully left subclavian approach. A chest x-ray shows the passage of the catheter following a left paramediastinal course without crossing the midline. The thoracic computed tomography (CT) scan showed catheter following the classic trajectory of a persistent left superior vena cava (PLSVC). Figure 1. All three ports of the line were normally functioning and the blood gas analysis was suggestive of venous blood sampling.