Aortic placement of central line

Case contributed by Stefan Tigges
Diagnosis almost certain


Difficult central line placement.

Patient Data

Age: 25 years
Gender: Male

Left subclavian catheter tip projects over the expected location of the aorta. No pneumothorax, lungs clear.

Case Discussion

Central lines that project to the left of the spine can be either extra- or intravascular. If intravascular, the line can be either venous (left superior vena cava or hemi-azygos) or arterial (aorta). A blood gas may be helpful to differentiate venous from arterial placement. In this case, the line was felt to be in the aorta and was removed without incident.

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