Inadvertent placement of pulmonary artery catheter in persistent left superior vena cava, detected by transesophageal echocardiography

Abstract

Pulmonary artery catheterization (PAC) is useful for monitoring critically ill patients. Several reports have documented that catheterization of the persistent left superior vena cava (PLSVC) has been associated with serious complications. Herein, we report inadvertent placement of a PAC in the PLSVC through the coronary sinus after mitral valve repair surgery, confirmed by transesophageal echocardiography (TEE) in the ICU. We experienced difficulty in detecting inadvertent placement of a PAC in the PLSVC by chest X-ray and pulmonary artery pressure waveform due to pre-existing cardiomegaly or the situation where percutaneous cardiopulmonary support is provided; TEE might be useful for detecting incorrect PAC insertion.