An 83-year-old man had chronic renal failure secondary to diabetes mellitus and hypertension. A temporary venous hemodialysis catheter was inserted because of a poorly functioning arteriovenous fistula in the right forearm. A left internal jugular venous line was introduced and good flow was observed. Post-placement anteroposterior and lateral chest radiographs (Figs. 1 and 2) revealed that the catheter was positioned in a persistent left superior vena cava (arrows). This anomaly occurs in 0.3% of the general population and 3% to 4% of patients with congenital heart disease. This patient had no clinical evidence of congenital heart disease.
Footnotes
Section Editors: David P. Girvan, MD, and Nis Schmidt, MD
Submissions to Surgical Images should be sent to Dr. David P. Girvan, Victoria Hospital Corporation, PO Box 5375, Station B, London ON N6A 5A5 or to Dr. Nis Schmidt, Department of Surgery, St. Paul’s Hospital, 1081 Burrard St., Vancouver BC V6Z 1Y6