• B Menéndez, S García del Valle, R C Marcos, J Azofra, and J Gomez-Arnau.
• Anaesthesiology Department, Clínica Puerta de Hierro, San Martín de Porres, Madrid, Spain.
• Can J Anaesth. 1996 Jun 1;43(6):626-8.

PurposeThis report deals with the case of a patient who presented persistence of left superior vena cava (LSVC). This disorder was discovered following placement of a catheter in pulmonary artery via the left subclavian vein.Clinical FeaturesThe patient was a 67-yr-old woman who, while in the intensive care unit after undergoing coronary revascularization with extracorporeal circulation, required pulmonary artery catheterization to guide resuscitation. Placement of the catheter proved to be difficult as the advance of the catheter was impeded. A normal pulmonary artery pressure wave was eventually detected at a distance of approximately 70 cm. Chest x-ray showed a catheter route suggestive of persistent LSVC.ConclusionA diagnosis of persistent LSVC should be considered whenever there appears to be some obstacle to central venous or pulmonary artery catheterization, especially in patients with congenital heart disease, since this disorder can have important clinical consequences.

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