Insertion of a totally implantable venous access port in a patient with isolated persistent left superior vena cava: A case report_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZENG Zhikai ,  ZOU Guowen ,  YU Bentong

1. Department of Thoracic Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000,P. R. China;

Corresponding author：

ZOU Guowen, Email: guowenzou1988@163.com; YU Bentong, Email: yubentong@126.com

Keywords：

Isolated persistent left superior vena cava; totally implantable venous access port; congenital body venous malformation; case report

DOI：

10.7507/1007-4848.202312010

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Persistent left superior vena cava (PLSVC) with absence of right superior vena cava (SVC), also known as isolated PLSVC, is a relatively rare type of congenital body venous malformation. Isolated PLSVC is asymptomatic, however, it will bring clinical difficulties to the implantation of the totally implantable venous access port (TIVAP). We reported a 41 years, male patient with esophageal cancer, who needed neoadjuvant chemoimmunotherapy. Through doppler ultrasonography, computed tomography (CT) and vascular 3D-reconstruction, we found him to be a patient with PLSVC with absence of right SVC before the insertion of TIVAP. Hence, we chose the left approach in which the needle was inserted into the sternocleidomastoid clavicular head lateral notch in left supraclavicular fossa as the puncture point. The depth of the catheter tip from the root of the neck to the puncture point was 21.5 cm and the catheter tip was located at the junction of the PLSVC and the right atrium, at the dilated coronary sinus. The procedure was successful and the patient received expected neoadjuvant chemotherapy combined with immunotherapy after operation, and anticoagulant therapy was performed to prevent thrombosis in coronary sinus and superior vena cava. There was no major catheter-related complication during the period of TIVAP.

Citation： ZENG Zhikai, ZOU Guowen, YU Bentong. Insertion of a totally implantable venous access port in a patient with isolated persistent left superior vena cava: A case report. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(4): 639-642. doi: 10.7507/1007-4848.202312010 Copy

1.	Povoski SP, Khabiri H. Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol, 2011, 9: 173.
2.	Van Walleghem J, Depuydt S, Schepers S. Insertion of a totally implantable venous access port in a patient with persistent left superior vena cava (PLSVC). Acta chirurgica Belgica, 2018, 118(1): 68-71.
3.	Ootaki Y, Yamaguchi M, Yoshimura N, et al. Unroofed coronary sinus syndrome: Diagnosis, classification, and surgical treatment. J Thorac Cardiovasc Surg, 2003, 126(5): 1655-1656.
4.	Ichikawa T, Hara T, Koizumi J, et al. Persistent left superior vena cava with absent right superior vena cava in adults: CT and clinical findings. Japanese J Radiol, 2020, 38(11): 1046-1051.
5.	Minniti S, Visentini S, Procacci C. Congenital anomalies of the venae cavae: Embryological origin, imaging features and report of three new variants. Eur Radiol, 2002, 12(8): 2040-2055.
6.	Heye T, Wengenroth M, Schipp A, et al. Persistent left superior vena cava with absent right superior vena cava: Morphological CT features and clinical implications. Intern J Cardiol, 2007, 116(3): e103-e105.
7.	Uçar O, Paşaoğlu L, Ciçekçioğlu H, et al. Persistent left superior vena cava with absent right superior vena cava: A case report and review of the literature. Cardiovas J Africa, 2010, 21(3): 164-166.
8.	Hara Y, Ota K, Fujita M, et al. Absence of right superior vena cava that was not detected by insertion of a pulmonary arterial catheter via the right internal jugular vein. J Clin Monit, 1994, 10(3): 210-212.
9.	Srivastava V, Mishra P, Kumar S, et al. Persistent left SVC with absent right SVC: A rare anomaly. J Card Surg, 2007, 22(6): 535-536.
10.	Ratliff HL, Yousufuddin M, Lieving WR, et al. Persistent left superior vena cava: Case reports and clinical implications. Intern J Cardiol, 2006, 113(2): 242-246.
11.	熊倩, 俞杉, 吴强, 等. 孤立性永存左上腔静脉患者植入起搏器1例. 临床心血管病杂志, 2019, 35(9): 866-868.
12.	Machevin-Surugue E, David N, et al. Dilated coronary sinus in prenatal echocardiography; Identification, associations and outcome. Prenatal diagnosis. 2002, 22(10): 898-902.
13.	Kim YG, Han S, Choi JI, et al. Impact of persistent left superior vena cava on radiofrequency catheter ablation in patients with atrial fibrillation. Europace, 2019, 21(12): 1824-1832.
14.	Eckardt L. Automaticity in the coronary sinus. J Cardiovasc Electrophysiol, 2002, 13(3): 288-289.
15.	Sheikh AS, Mazhar S. Persistent left superior vena cava with absent right superior vena cava: Review of the literature and clinical implications. Echocardiography (Mount Kisco, NY), 2014, 31(5): 674-679.
16.	Bisoyi S, Jagannathan U, Dash AK, et al. Isolated persistent left superior vena cava: A case report and its clinical implications. Ann Card Anaesth, 2017, 20(1): 104-107.
17.	Webb WR, Gamsu G, Speckman JM, et al. Computed tomographic demonstration of mediastinal venous anomalies. Am J Roentgenol, 1982, 139(1): 157-161.
18.	Demos TC, Posniak HV, Pierce KL, et al. Venous anomalies of the thorax. Am J Roentgenol, 2004, 182(5): 1139-1150.
19.	谭小利, 谢凤, 伍莎莎等. 孤立性永存左上腔静脉植入无导线起搏器一例. 中国心脏起搏与心电生理杂志, 2023, 37(4): 351-352.
20.	Tang PT, Chan K. Isolated persistent left superior vena cava. N En J Med, 2022, 386(9): 879.

1. Povoski SP, Khabiri H. Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol, 2011, 9: 173.
2. Van Walleghem J, Depuydt S, Schepers S. Insertion of a totally implantable venous access port in a patient with persistent left superior vena cava (PLSVC). Acta chirurgica Belgica, 2018, 118(1): 68-71.
3. Ootaki Y, Yamaguchi M, Yoshimura N, et al. Unroofed coronary sinus syndrome: Diagnosis, classification, and surgical treatment. J Thorac Cardiovasc Surg, 2003, 126(5): 1655-1656.
4. Ichikawa T, Hara T, Koizumi J, et al. Persistent left superior vena cava with absent right superior vena cava in adults: CT and clinical findings. Japanese J Radiol, 2020, 38(11): 1046-1051.
5. Minniti S, Visentini S, Procacci C. Congenital anomalies of the venae cavae: Embryological origin, imaging features and report of three new variants. Eur Radiol, 2002, 12(8): 2040-2055.
6. Heye T, Wengenroth M, Schipp A, et al. Persistent left superior vena cava with absent right superior vena cava: Morphological CT features and clinical implications. Intern J Cardiol, 2007, 116(3): e103-e105.
7. Uçar O, Paşaoğlu L, Ciçekçioğlu H, et al. Persistent left superior vena cava with absent right superior vena cava: A case report and review of the literature. Cardiovas J Africa, 2010, 21(3): 164-166.
8. Hara Y, Ota K, Fujita M, et al. Absence of right superior vena cava that was not detected by insertion of a pulmonary arterial catheter via the right internal jugular vein. J Clin Monit, 1994, 10(3): 210-212.
9. Srivastava V, Mishra P, Kumar S, et al. Persistent left SVC with absent right SVC: A rare anomaly. J Card Surg, 2007, 22(6): 535-536.
10. Ratliff HL, Yousufuddin M, Lieving WR, et al. Persistent left superior vena cava: Case reports and clinical implications. Intern J Cardiol, 2006, 113(2): 242-246.
11. 熊倩, 俞杉, 吴强, 等. 孤立性永存左上腔静脉患者植入起搏器1例. 临床心血管病杂志, 2019, 35(9): 866-868.
12. Machevin-Surugue E, David N, et al. Dilated coronary sinus in prenatal echocardiography; Identification, associations and outcome. Prenatal diagnosis. 2002, 22(10): 898-902.
13. Kim YG, Han S, Choi JI, et al. Impact of persistent left superior vena cava on radiofrequency catheter ablation in patients with atrial fibrillation. Europace, 2019, 21(12): 1824-1832.
14. Eckardt L. Automaticity in the coronary sinus. J Cardiovasc Electrophysiol, 2002, 13(3): 288-289.
15. Sheikh AS, Mazhar S. Persistent left superior vena cava with absent right superior vena cava: Review of the literature and clinical implications. Echocardiography (Mount Kisco, NY), 2014, 31(5): 674-679.
16. Bisoyi S, Jagannathan U, Dash AK, et al. Isolated persistent left superior vena cava: A case report and its clinical implications. Ann Card Anaesth, 2017, 20(1): 104-107.
17. Webb WR, Gamsu G, Speckman JM, et al. Computed tomographic demonstration of mediastinal venous anomalies. Am J Roentgenol, 1982, 139(1): 157-161.
18. Demos TC, Posniak HV, Pierce KL, et al. Venous anomalies of the thorax. Am J Roentgenol, 2004, 182(5): 1139-1150.
19. 谭小利, 谢凤, 伍莎莎等. 孤立性永存左上腔静脉植入无导线起搏器一例. 中国心脏起搏与心电生理杂志, 2023, 37(4): 351-352.
20. Tang PT, Chan K. Isolated persistent left superior vena cava. N En J Med, 2022, 386(9): 879.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Insertion of a totally implantable venous access port in a patient with isolated persistent left superior vena cava: A case report

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content