Sinha Vijay Kumar, Chauhan Vidhu, Agarwal Saloni, Mishra Mohit
Department of Nephrology & Kidney Transplant, Max Super Speciality Hospital, Noida, Uttar Pradesh, India.
Catheter Cardiovasc Interv. 2025 Aug;106(2):1107-1110. doi: 10.1002/ccd.31648. Epub 2025 Jun 2.
Persistent Left Superior Vena Cava (PLSVC) is a rare congenital vascular anomaly occurring in 0.3%-0.5% of the general population. While often asymptomatic, it may pose challenges during central venous catheterization. We report the case of a 24-year-old male with Stage 5 chronic kidney disease (CKD) requiring urgent hemodialysis. A right internal jugular vein catheter was successfully placed, but post-procedural imaging revealed an unusual catheter trajectory toward the left mediastinum. CT angiography confirmed PLSVC of Schummer's Type 2, characterized by the absence of the right superior vena cava and left SVC draining into the right atrium via a dilated coronary sinus. Hemodialysis was performed successfully with gradual flow rate adjustments and close monitoring. This case emphasizes the importance of early recognition and management of vascular anomalies to ensure procedural success.
永存左上腔静脉（PLSVC）是一种罕见的先天性血管异常，在普通人群中的发生率为0.3%-0.5%。虽然通常无症状，但在中心静脉置管过程中可能会带来挑战。我们报告一例24岁患有5期慢性肾脏病（CKD）需要紧急血液透析的男性病例。成功置入了右颈内静脉导管，但术后影像学检查显示导管走向左纵隔的轨迹异常。CT血管造影证实为舒默2型PLSVC，其特征为右上腔静脉缺如，左SVC通过扩张的冠状窦引流至右心房。通过逐渐调整流速并密切监测，成功进行了血液透析。该病例强调了早期识别和处理血管异常以确保手术成功的重要性。
