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CC BY 4.0 · Surg J (N Y) 2022; 08(02): e117-e122
DOI: 10.1055/s-0042-1749124
Case Report

Persistent Left Superior Vena Cava Associated with Right Aberrant Subclavian Artery Detected during Totally Implantable Vascular Access Device Insertion

Etienne El-Helou
1   Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
,
Manar Zaiter
2   Department of Radiology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
,
Ammar Shall
1   Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
,
Youssef Sleiman
1   Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
,
Gabriel Liberale
1   Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
,
Catalin-Florin Pop
1   Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
› Institutsangaben Funding None.
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Abstract

Introduction Persistent left superior vena cava (PLSVC) is a rare vascular malformation, with several cases reported in the English literature. The diagnosis is made incidentally, during cardiovascular imaging or when a catheter is placed in the left jugular or subclavian vein. They are without associated hemodynamic alterations, except if they have left atrial drainage or an associated dilation of the coronary sinus. If necessary, long-term PSLVC catheterization with right atrial drainage is safe.

Case Presentation We report the case of 40-year-old man, admitted for placement of totally implantable vascular access device (TIVAD) on the same day of his first chemotherapy. A disease localized to the right neck made it impossible to puncture on the right. During the puncture of the left internal jugular vein, the diagnosis of PLSVC was made. Postoperative investigations confirmed the diagnosis and showed the presence of the right superior vena cava to which it was connected by the left brachiocephalic vein. They also confirmed the drainage of PLSVC into the coronary sinus. In addition, they demonstrated the presence of an associated right aberrant subclavian artery of direct aortic origin. Chemotherapy was administered safely and the port was removed 9 months after insertion without any problem.

Conclusion This is one of the rare cases reported in the English literature of PLSVC diagnosed during TIVAD insertion and the first to report an associated vascular malformation. We publish it to encourage physicians to think about this differential diagnosis and to carefully perform the appropriate investigations before using the port.

Keywords

persistent left superior vena cava - portacath - Hodgkin's lymphoma - case report


Publikationsverlauf

Eingereicht: 03. September 2021

Angenommen: 17. Februar 2022

Artikel online veröffentlicht:
14. Juni 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Povoski SP, Khabiri H. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol 2011; 9: 173
    CrossrefPubMedGoogle Scholar
  • 2 Gibson F, Bodenham A. Misplaced central venous catheters: applied anatomy and practical management. Br J Anaesth 2013; 110 (03) 333-346
    CrossrefPubMedGoogle Scholar
  • 3 Evers C, Gazis A, Thuss-Patiance W, Kretzschmar A. Misplacement of a port catheter: a differentiated view. Case Rep Radiol 2017; 2017: 1640431
    PubMedGoogle Scholar
  • 4 Van Walleghem J, Depuydt S, Schepers S. Insertion of a totally implantable venous access port in a patient with persistent left superior vena cava (PLSVC). Acta Chir Belg 2018; 118 (01) 68-71
    CrossrefPubMedGoogle Scholar
  • 5 Zhou Q, Murthy S, Pattison A, Werder G. Central venous access through a persistent left superior vena cava: a case series. J Vasc Access 2016; 17 (05) e143-e147
    CrossrefPubMedGoogle Scholar
  • 6 Liberale G. Totally implantable vascular access device (TIVAD) placement: a modified technique that takes post-procedure aesthetic aspects into account. Support Care Cancer 2017; 25 (04) 1137-1140
    CrossrefPubMedGoogle Scholar
  • 7 Azizova A, Onder O, Arslan S, Ardali S, Hazirolan T. Persistent left superior vena cava: clinical importance and differential diagnoses. Insights Imaging 2020; 11 (01) 110 Erratum in: Insights Imaging 2021 Apr 16;12(1):49
    CrossrefPubMedGoogle Scholar
  • 8 Sylwestrzak O, Respondek-Liberska M. Gradual diagnosis and clinical importance of prenatally detected persistent left superior vena cava with absent right superior vena cava - a case report and literature review. J Ultrason 2020; 20 (81) e146-e150
    CrossrefPubMedGoogle Scholar
  • 9 Zhong YL, Long XM, Jiang LY. et al. Surgical treatment of dextroversion, isolated persistent left superior vena cava draining into the left atrium. J Card Surg 2015; 30 (10) 767-770
    CrossrefPubMedGoogle Scholar
  • 10 Iovino F, Auriemma PP, Viscovo LD, Scagliarini S, DI Napoli M, DE Vita F. Persistent left superior vena cava: a possible contraindication to chemotherapy and total parenteral nutrition in cancer patients. Oncol Lett 2012; 4 (04) 759-762
    CrossrefPubMedGoogle Scholar
  • 11 Uemura M, Suwa F, Takemura A, Toda I, Morishita A. Classification of persistent left superior vena cava considering presence and development of both superior venae cavae, the anastomotic ramus between superior venae cavae, and the azygos venous system. Anat Sci Int 2012; 87 (04) 212-222
    CrossrefPubMedGoogle Scholar
  • 12 Lodhi HA, Morcos R, Bansal P. et al. Transcatheter closure of persistent left superior vena cava draining to pulmonary vein: a rare entity. JACC Case Rep 2020; 2 (08) 1120-1123
    CrossrefPubMedGoogle Scholar
  • 13 Jheengut Y, Fan B. Intraoperative identification of persistent left superior vena cava with intracavitary electrocardiogram during venous port insertion: a report of eight cases. J Vasc Access 2021; 22 (05) 834-839
    CrossrefPubMedGoogle Scholar
  • 14 Laurenzi L, Natoli S, Pelagalli L. et al. Long-term central venous catheterization via persistent left superior vena cava: a case report. Support Care Cancer 2003; 11 (03) 190-192
    CrossrefPubMedGoogle Scholar
  • 15 Dinasarapu CR, Adiga GU, Malik S. Recurrent cerebral embolism associated with indwelling catheter in the presence of anomalous neck venous structures. Am J Med Sci 2010; 340 (05) 421-423
    CrossrefPubMedGoogle Scholar