Korean J Anesthesiol.  2014 Dec;67(6):429-432. 10.4097/kjae.2014.67.6.429.

Persistent left superior vena cava: diagnosed by bedside echocardiography in a liver transplant patient: a case report

• Kim H
• Kim JH
• Lee H

• KMID: 2425280
• DOI: http://doi.org/10.4097/kjae.2014.67.6.429

Abstract

In most cases, persistent left superior vena cava (PLSVC) is asymptomatic and discovered accidentally. This case involves a 43-year-old male who underwent an emergency cadaveric liver transplantation. Postoperatively, the left internal jugular vein was cannulated using a sono-guided Seldinger technique in the intensive care unit. But the chest X-ray showed that the catheter followed the left paramediastinal course instead of crossing midline to the right to enter the superior vena cava. In consideration of the patient's status, an intra-arterial or extra-vascular placement could be excluded. For a diagnosis, we performed a bed-side transthoracic echocardiography with an agitated saline micro-bubble test. When agitated saline was injected through the catheter, the coronary sinus was initially opacified, and then the right atrium followed. In conclusion, we were able to make a diagnosis of PLSVC by a bedside test without radiation exposure.

Keyword

Congenital heart defects; Contrast media; Diagnostic use; Echocardiography

MeSH Terms

Adult
Cadaver
Catheters
Contrast Media
Coronary Sinus
Diagnosis
Dihydroergotamine
Echocardiography*
Emergencies
Heart Atria
Heart Defects, Congenital
Humans
Intensive Care Units
Jugular Veins
Liver Transplantation
Liver*
Male
Thorax
Vena Cava, Superior*
Contrast Media
Dihydroergotamine