Objective: To report a case of partial anomalous pulmonary vein drainage of the left lower lobe diagnosed after central venous cannulation.
Design: Retrospective case review.
Setting: Intensive care unit.
Patient: A 76-yr-old woman with obstructive acute renal failure requiring hemodialysis.
Interventions: Central venous cannulation and hemodialysis.
Measurements and Main Results: The diagnosis was suggested by chest radiography after placement of a central venous catheter through the left internal jugular vein. Pressure measurements at the tip of the catheter showed a venous waveform. Oxygen blood content on samples of blood was higher than on peripheral arterial blood. Computed tomography with intravenous contrast was not conclusive. Diagnosis was confirmed with transcatheter phlebography.
Conclusions: It is important for the intensivist to be aware of this infrequent variant when a central venous catheter takes an abnormal route and drains low-pressure, arterialized blood.
From the Unidade de Urgência Médica, Hospital de São José, Lisboa, Portugal.
Address requests for reprints to: G. Sobrinho, MD, Rua Tomás da Anunciação 169 1 D, 1350-326 Lisboa, Portugal. E-mail: firstname.lastname@example.org
It is important for the intensivist to be aware of the possibility of partial anomalous pulmonary vein return to the superior vena cava or to the right atrium when a central venous catheter takes an abnormal route and drains low-pressure, arterialized blood.