Wednesday May 19, 2010

Case: 27 year old diabetic male is admitted to hospital and get diagnosed with osteomyelitis. After surgical intervention long term antibiotics are planned and PICC line is inserted. Following image is obtained after PICC insertion (arrows showing PICC path). What could be your concern?

Persistent Left Superior Vena Cava (SVC)

0.3% of normal population have Left Superior Vena Cava (SVC). In most cases, the right SVC is also present (i.e. double SVC). Left SVC courses lateral to the aortic arch, main pulmonary artery, anterior to the left hilum and typically enters the coronary sinus that drains into the right atrium. In some cases, left SVC enters the left atrium. The variation, in isolation, is considered benign but but may be very frequently associated with cardiac abnormalities. Left SVC draining into the left atrium is highly associated with commonly ASD.