KMID : 0356920140670060429
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Korean Journal of Anesthesiology 2014 Volume.67 No. 6 p.429 ~ p.432
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Persistent left superior vena cava: diagnosed by bedside echocardiography in a liver transplant patient: a case report
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Kim Hye-Rim
Kim Jin-Hee Lee Han-Nah
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Abstract
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In most cases, persistent left superior vena cava (PLSVC) is asymptomatic and discovered accidentally. This case involves a 43-year-old male who underwent an emergency cadaveric liver transplantation. Postoperatively, the left internal jugular vein was cannulated using a sono-guided Seldinger technique in the intensive care unit. But the chest X-ray showed that the catheter followed the left paramediastinal course instead of crossing midline to the right to enter the superior vena cava. In consideration of the patient¡¯s status, an intra-arterial or extra-vascular placement could be excluded. For a diagnosis, we performed a bed-side transthoracic echocardiography with an agitated saline micro-bubble test. When agitated saline was injected through the catheter, the coronary sinus was initially opacified, and then the right atrium followed. In conclusion, we were able to make a diagnosis of PLSVC by a bedside test without radiation exposure.
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KEYWORD
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Congenital heart defects, Contrast media, Diagnostic use, Echocardiography
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