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Incidental finding of persistent left superior vena cava after ‘bubble study’ verification of central venous catheter
  1. Miguel Agustin Pardinas Gutierrez,
  2. Luis A Escobar,
  3. Vanessa Blumer,
  4. Jorge Luis Cabrera
  1. Department of Medicine, Jackson Memorial Hospital, Miami, Florida, USA
  1. Correspondence to Dr Miguel Agustin Pardinas Gutierrez, miguel.pardinasguti{at}


We report a case of a patient with septic shock who underwent central venous catheter placement in the left internal jugular vein, and a bedside ultrasound ‘bubble study’ revealed venous cannulation. A chest X-ray postprocedure revealed concern for arterial system catheterisation. However, the possibility of a persistent left superior vena cava was discussed and confirmed with a formal transthoracic echocardiogram and CT. This case demonstrates the importance of ultrasound-guided visualisation of anatomical structures in real time during central venous catheterisation. Other similar cases from the literature are briefly described.

  • cardiovascular system
  • intensive care
  • medical management
  • radiology
  • vascular surgery

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  • Contributors All authors contributed to the writing of this article. We all took part in the clinical care of the patient. Specific work regarding the writing of this article is explained as follows: LAE helped in reviewing previous case reports similar to our own and contributed with references and in writing discussion part; VB participated in the overall writing and proof-reading of the described work; MAPD is the corresponding author and helped in writing the template, including the case report itself, acquiring consent,choosing images until submission of the article; JLC was our attending representative on the case and serves as guarantor for the overall content; he helped in choosing the appropriate images and the video file for this case report, performed proof-reading and made suggestions to improve the content of our work. He suggested the idea of publication in the first place.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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