| Accidental insertion of a percutaneous venovenous cannula into the persistent left superior vena cava of a patient undergoing liver transplantation. | |
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MedLine Citation:
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PMID: 21553167 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Persistent left superior vena cava (PLSVC) is a rare congenital vascular abnormality found in 0.3% of the general population. We report herein a rare complication involving the accidental insertion of a large bore cannula into the PLSVC during liver transplantation (LT). CLINICAL FEATURES: A 63-yr-old man with primary sclerosing cholangitis presented for LT. Given the existence of a tunnelled dialysis catheter in the right internal jugular vein (IJV) and a triple lumen catheter via the left IJV, insertion of an 18 French cannula for venovenous bypass (VVB) was performed via the left IJV using the existing triple lumen cannula as a conduit for a guidewire. Upon initiation of VVB, profound systemic hypotension occurred, and liver transplantation was completed without the further use of VVB. A chest x-ray confirmed a malposition of the VVB cannula with a large left hemothorax. A mini-sternotomy was performed for removal of the VVB cannula, which was found to be inserted in the PLSVC. Retrospectively, the presence of PLSVC was not anticipated due to a normal superior vena cava and a left innominate vein, as revealed by the course of a pre-existing left internal jugular vein triple lumen catheter on a preoperative chest x-ray, and due to a normal-sized coronary sinus on preoperative echocardiography. CONCLUSION: Malpositioning of a venous cannula in a PLSVC should be anticipated as one of the potential complications of vascular access via the left internal jugular vein. |
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Authors:
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Kristin L Schreiber; Takashi Matsusaki; Brian C Bane; Christian A Bermudez; Ibtesam A Hilmi; Tetsuro Sakai |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2011-05-07 |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 58 ISSN: 1496-8975 ISO Abbreviation: Can J Anaesth Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-23 Completed Date: 2011-10-24 Revised Date: 2012-02-23 |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: United States |
Other Details:
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Languages: eng Pagination: 646-9 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, The McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore, M469.11, 200 Lothrop Street, Pittsburgh, PA 15213, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Catheterization, Central Venous
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adverse effects* Cholangitis, Sclerosing / surgery Humans Hypotension / etiology Jugular Veins Liver Transplantation / methods* Male Medical Errors Middle Aged Vena Cava, Superior / abnormalities* |
| Comments/Corrections | |
Comment In:
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Can J Anaesth. 2012 Feb;59(2):232-3; author reply 233
[PMID:
22228294
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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