A Case of Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava Diagnosed During Internal Jugular Venous Catheterization for Acute Hemodialysis / 대한신장학회잡지

ABSTRACT

Persistent left superior vena cava(PLSVC) derives from abnormally persistent patency of an embryological vessel normally present during the early developmental period. The incidence of PLSVC is 0.3% in healty persons, 4.8% in patients with congenital heart anomaly. Most of the patients with PLSVC have normal right superior vena cava (RSVC), but PLSVC plus absent RSVC is very rare, especially in those without congenital heart anomalies. We experienced a case of PLSVC and absent RSVC during an insertion of internal jugular venous catheter for acute hemodialysis. A 53-year-old female was admitted due to uremia for initiation of dialytic therapy. She had long history of diabetic nephropathy but without congenital heart anomalies. We inserted a dual lumen catheter for acute hemodialysis via right internal jugular vein. On the chest x-ray film taken after the insertion of the catheter, we detected unusual course of the catheter curved to the left. PLSVC and absent RSVC was confirmed by normal saline contrast echocardiography and CT angiograpy.