A 25-year-old male with a history of end-stage renal disease on hemodialysis (HD) was admitted for methicillin-sensitive staphylococcus aureus bacteremia. Appropriate antibiotics were started, and his HD catheter was replaced with a temporary one in the left internal jugular vein (LIJ). A follow-up chest X-ray revealed an unusual course of the catheter and persistent left superior vena cava (PLSVC) was suspected (Fig. 1A). A follow-up cardiac computed tomography (CT) confirmed the presence of PLSVC containing HD catheter that drains into coronary sinus (CS). It also showed right-sided SVC and inferior vena cava drain appropriately into the right atrium (RA) (Fig. 1B, C). The LIJ HD catheter was replaced with a right internal jugular vein one. Transthoracic and transesophageal echocardiogram revealed dilated CS (Figs 1D, ​,22).

Essa A, Sharma GK. Unexpected course of central venous catheter; persistent left superior vena cava. Oxf Med Case Reports. 2022 Nov 24;2022(11):omac121. doi: 10.1093/omcr/omac121. PMID: 36447468; PMCID: PMC9693913.