We report an unusual presentation of the P wave and QRS complex during ECG-guided endocavitary assessment of the proper location of the central venous catheter in a pre-term infant operated on for esophageal atresia. The P wave and QRS complex had a normal morphology, but lay specularly to normal above the isoelectric line. The chest X-ray showed that the unusual ECG pattern was due to the left paracardiac position of the catheter, just lateral to the aortic arch within a persistent left superior vena cava.
TakT., CrouchE., DrakeG.B.Persistent left superior vena cava: incidence, significance and clinical correlates. Int J Cardiol2002; 82: 91–3.
2.
Gonzales-JuanateyC., TestaA., VidanJ.Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review. Clin Cardiol2004; 27: 515–8.
3.
DanielpourP.J., AalbergJ.K., El-RameyM., SivinaM., WodnickiH.Persistent left superior vena cava: an incidental finding during central venous catheterization - a case report. Vasc Endovascular Surg2005; 39: 109–11.
4.
SerafiniG.P., PietrobonoP., CornaraG.Location of central venous catheter in children by endocavitary ECG; a new technique. Clin Nutr1985; 4: 201–2.
5.
ParigiG.B., VergaG.Accurate placement of central venous catheter in pediatric patients using endocavitary electrocardiography: reassessment of a personal technique. J Pediatr Surg1997; 32: 1226–8.
