Central venous line in left-sided superior vena cava

Case contributed by Dr Timothy Wong

Presentation

Right-sided breast cancer. Referred for left-sided PICC line insertion.

Patient Data

Age: 40 years
Gender: Female

The guide wire was noted to extend along the left mediastinum and with advancement of the guide wire, it extended into the expected region of inferior vena cava and right hepatic vein. The final position of the PICC line is projecting over the expected region of the left SVC and right atrium.  

Case Discussion

Duplicated SVC is a rare anatomical variant that occurs in about 0.3 % of the population. In this case report, the patient was found to have an unusual course of guide-wire. Prior imaging was reviewed and left-sided SVC was confirmed. The final position of the PICC line is projecting over the left SVC and right atrium. No acute complication. 

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