Aplasia of the superior vena cava and persistent superior left vena cava in a 3-year-old child: Case report

BACKGROUND: Structural features of the patient’s vascular system can cause unintended complications when providing vascular access and can disorient the specialist in assessing the location of the installed catheter. This study aimed to demonstrate anatomical features of the vascular system of the superior vena cava and diagnostic steps when providing vascular access in a child.

CASE REPORT: Patient K (3 years old) was on planned maintenance of long-term venous access. Preliminary ultrasound examination of the superior vena cava did not reveal any abnormalities. Function of the right internal jugular vein under ultrasound control was performed without technical difficulties; a J-formed guidewire was inserted into the vessel lumen. X-ray control revealed its projection in the left heart, which was regarded as a technical complication, so the conductor was removed. A further attempt to insert a catheter through the right subclavian vein led to the same result. For a more accurate diagnosis, the child underwent computed angiography of the superior vena cava system. Congenital anomalies of the vascular system included aplasia of the superior vena cava and persistent left superior vena cava. Considering the information obtained, the Broviac catheter was implanted under ultrasound control through the left internal jugular vein without technical difficulties with the installation of the distal end of the catheter into the left brachiocephalic vein under X-ray control.

CONCLUSION: A thorough multifaceted study of the vascular anatomy helps solve the anatomical issues by ensuring vascular access and preventing the risks of complications.