case_images: PMC11164207_01
case_images: Chest radiograph showing the left parasternal location of the central venous catheter (CVC) with a guidewire retained in the right atrium through the PLSVC and the coronary sinus (brightness and contrast changed for better visualisation of the guidewire).
case_images: VHRM-20-245-g0001.jpg
case_images: PMC11164207_01_VHRM-20-245-g0001.jpg
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case_images: The radiologist described the left parasternal location of the CVC and suspected a retained guidewire with an end-loop in the right atrium (Figure 1).
case_images: Transthoracic echocardiography ("shortened" apical 4-chamber view in supine) shows a visibly dilated coronary sinus (CS) with the guidewire inside.
case_images: VHRM-20-245-g0002.jpg
case_images: PMC11164207_01_VHRM-20-245-g0002.jpg
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case_images: Echocardiography revealed a dilated coronary sinus (17 mm) with a hyperechoic linear echo of the guidewire (Figure 2).
case_images: Focused echocardiography of the right atrium during a bubble test (subcostal 4-chamber view). (A) Focus on the right atrium with visualization of the terminal part of the guidewire (arrow). The dotted line indicates the out-of-plane part of the guidewire leading toward the ostium of the coronary sinus on the interatrial septum (asterisk) prior to the agitated saline injection; (B) Visual confirmation of early bubble entrance into the right atrium (arrowheads); (C) Late phase of bubble entry into the right atrium (arrowheads).
case_images: VHRM-20-245-g0003.jpg
case_images: PMC11164207_01_VHRM-20-245-g0003.jpg
case_images: f0003
case_images: PLSVC was diagnosed by agitated saline injection (bubble test) through the left antebrachial vein with visual confirmation of bubble entrance from the coronary sinus ostium on the interatrial septum (Figure 3).
case_images: Contrast-enhanced computed tomography of the thorax. (A) Coronal view shows the proximal part of the PLSVC with a minor LBCV connecting to the SVC (note the central vein catheter within the SVC): (B) Sagittal view shows the inflow of the PLSVC into the coronary sinus.
case_images: VHRM-20-245-g0004.jpg
case_images: PMC11164207_01_VHRM-20-245-g0004.jpg
case_images: f0004
case_images: Contrast-enhanced computed tomography of the thorax was performed during hospitalization in the ICU after consulting with the pulmonologist, that confirmed PLSVC with drainage to the coronary sinus with a small-diameter left brachiocephalic vein connecting the PLSVC and the right superior vena cava (SVC) (Figure 4).