Aydın Kutlay, Tokur Murat Emre, Ergan Begüm
Department of Intensive Care Unit, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Turk Thorac J. 2018 Jan;19(1):46-48. doi: 10.5152/TurkThoracJ.2017.17020. Epub 2017 Jul 21.
A persistent left-sided superior vena cava (PLSVC) is the most frequent abnormality of the venous system; however, it is not a very well-known variation among physicians. Herein we report the case of a patient with a PLSVC who was diagnosed after central venous catheterization (CVC). An 80-year-old man was admitted to the emergency room with cardiopulmonary arrest. After the return of spontaneous circulation, CVC was blindly performed from the left jugular vein without any complications. However, routine chest X-ray after catheterization revealed that the catheter was moving down directly to the left heart. Thoracic computed tomography showed the right brachiocephalic vein draining into the left brachiocephalic vein and forming the left superior vena cava in front of the aortic arch. The left superior vena cava merged into the right atrium after crossing the left pulmonary artery. CVC is widely used in clinical practice, and therefore clinicians should be aware of possible variations in central veins, particularly during blind catheterization.
永存左侧上腔静脉（PLSVC）是静脉系统最常见的异常情况；然而，它在医生中并不是广为人知的变异。在此我们报告一例经中心静脉置管（CVC）后诊断为PLSVC的患者。一名80岁男性因心肺骤停被送入急诊室。自主循环恢复后，从左颈静脉盲目进行CVC，未出现任何并发症。然而，置管后的常规胸部X线显示导管直接向下进入左心。胸部计算机断层扫描显示右头臂静脉汇入左头臂静脉，并在主动脉弓前方形成左上腔静脉。左上腔静脉在穿过左肺动脉后汇入右心房。CVC在临床实践中广泛应用，因此临床医生应意识到中心静脉可能存在的变异，尤其是在盲目置管期间。
