Persistent Left Superior Vena Cava Leads to Catheter Malposition during PICC Port Placement

Abstract

Introduction

We present a case of peripherally inserted central catheter (PICC) port placement where the catheter had been malpositioned to the persistent left superior vena cava.

Methods

Despite the obvious elevation of the P-wave signaling proximity of the catheter tip to the sinus node, the catheter was not in the desired location within the superior vena cava or the right atrium, because of the presence of a persistent left superior vena cava. Computed tomography was used in order to locate the catheter.

Results

The catheter was located in the persistent left superior vena cava.

Conclusions

Malpositioning of the catheter in the persistent left superior vena cava occurs in 0.3%–0.5% of patents. The catheter was subsequently removed.