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"A chest wall venous infusion port was inserted via the left internal jugular vein. Due to the PLSVC, the catheter was adjusted to ensure proper placement" Wang et al (2024).
Implantable port placement via persistent left superior vena cava

Abstract:

Rationale: Persistent left superior vena cava (PLSVC) is a rare congenital venous anomaly occurring in approximately 0.3% to 0.5% of the population. The presence of PLSVC complicates central venous catheter placement, increasing procedural risks. This case report describes the successful placement of a chest wall venous infusion port in a patient with PLSVC, offering valuable insights for managing similar cases and ensuring safer clinical outcomes.

Patient concerns: A 51-year-old female, 3 weeks post-right breast cancer surgery, was admitted for her first adjuvant hemotherapy session. She requested the placement of a venous infusion port due to the prolonged duration of chemotherapy.

Diagnoses: Imaging studies suggested the presence of PLSVC. Echocardiography revealed a dilated coronary sinus, and subsequent chest computed tomography and angiography confirmed the presence of PLSVC.

Interventions: A chest wall venous infusion port was inserted via the left internal jugular vein. Due to the PLSVC, the catheter was adjusted to ensure proper placement.

Outcomes: The patient successfully completed chemotherapy without any complications or discomfort associated with the venous port. Imaging studies, including chest X-ray and computed tomography, confirmed proper port function and catheter positioning, with no evidence of thrombosis, infection, or other related issues. The patient remained in good overall condition throughout the treatment.

Lessons: Detailed preoperative evaluations, intraoperative imaging guidance, and postoperative follow-ups are crucial for the safe and effective management of PLSVC patients undergoing central venous catheter placement.

Reference:

Wang Z, Li R, Du Q, Zhang W, Wang Z. Successful placement of a chest wall venous infusion port via persistent left superior vena cava: A case report. Medicine (Baltimore). 2024 Oct 4;103(40):e39978. doi: 10.1097/MD.0000000000039978. PMID: 39465735; PMCID: PMC11460890.

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