Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report

Coimbra, Miguel T; Braga, Beatriz; Silva, Adriana; Sousa, Fernanda; Queirós, José

Publication

Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report

2023-08Journal article

dc.contributor.author	Coimbra, Miguel T
dc.contributor.author	Braga, Beatriz
dc.contributor.author	Silva, Adriana
dc.contributor.author	Sousa, Fernanda
dc.contributor.author	Queirós, José
dc.date.accessioned	2024-06-17T16:15:14Z
dc.date.available	2024-06-17T16:15:14Z
dc.date.issued	2023-08
dc.description.abstract	Persistent left superior vena cava (PLSVC) is the most frequent thoracic venous anatomical variant in the general population. Isolated PLSVC, without formation of the right superior vena cava, is described in 10% of cases of PLSVC only. While it can be associated with congenital heart disease, arrhythmias, and premature death, adult patients with PLSVC are mostly asymptomatic, and the diagnosis is usually accidental. We present the case of a 72-year-old male with end-stage renal disease who was started on urgent hemodialysis through a temporary non-tunneled femoral central venous catheter (CVC) in the SLED (slow low-efficiency dialysis) modality and later remained dependent on hemodialysis. At this stage, placement of a tunneled CVC in the right internal jugular vein was necessary and fluoroscopy guidance was not available. There were no complications during the procedure, but postoperative conventional chest radiography revealed an inadequate positioning of the CVC tip in the left hemithorax, crossing the midline. Subsequently, the diagnosis of PLSVC was obtained by performing a thoracic angio-CT scan, confirming CVC tip positioning inside the PLSVC, and also excluded the presence of cardiac defects or additional anatomical variations of the great vessels of the thorax. Early evaluation for the creation of autologous vascular access was started under our care, and there were no mechanical or other complications associated with hemodialysis sessions during early follow-up after discharge.	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.citation	Coimbra MT, Braga B, Silva A, Sousa F, Queirós J. Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report. Cureus. 2023;15(8):e44212. doi:10.7759/cureus.44212	pt_PT
dc.identifier.doi	10.7759/cureus.44212	pt_PT
dc.identifier.issn	2168-8184
dc.identifier.uri	http://hdl.handle.net/10400.16/2936
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Cureus, Inc.	pt_PT
dc.relation.publisherversion	https://www.cureus.com/articles/167295-accidental-diagnosis-of-isolated-persistent-left-superior-vena-cava-after-an-elective-central-venous-access-procedure-for-chronic-hemodialysis-clinical-implications-and-precautions-from-a-case-report#!/	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	pt_PT
dc.subject	central venous catheter (cvc)	pt_PT
dc.subject	chronic hemodialysis	pt_PT
dc.subject	chronic kidney disease (ckd)	pt_PT
dc.subject	computed tomography angiography (cta); persistent left superior vena cava (plsvc)	pt_PT
dc.title	Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.conferencePlace	United States of America	pt_PT
oaire.citation.issue	8	pt_PT
oaire.citation.startPage	e44212	pt_PT
oaire.citation.title	Cureus	pt_PT
oaire.citation.volume	15	pt_PT
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT