case_images: PMC10792061_01
case_images: Electrocardiogram manifestation during the process of advancing and retreating the catheter. P-wave changes were dynamically observed on lead II of IC-ECG. IC-ECG showed that, at 33 cm, sinus rhythm with positive P-waves; at about 34 cm, negative P-waves instead of positive P-waves appeared. As the catheter continued to advance, the amplitude of the negative P-wave gradually increased and reached the maximum, and then the P-wave began to become biphasic and the amplitude decreased. At 45 cm, the negative P-wave disappeared completely. This phenomenon occurred repeatedly with repeated insertions of the catheter.
case_images: fsurg-10-1254937-g001.jpg
case_images: PMC10792061_01_fsurg-10-1254937-g001.jpg
case_images: F1
case_images: This abnormal phenomenon occurred repeatedly with repeated insertions of the catheter (Figure 1).
case_images: Chest x-ray findings. A chest x-ray was taken to confirm the tip location and showed that the catheter was positioned at the left paramediastinal border near the T8 vertebrae.
case_images: fsurg-10-1254937-g002.jpg
case_images: PMC10792061_01_fsurg-10-1254937-g002.jpg
case_images: F2
case_images: T8 vertebrae, rather than crossing the midline to access the right SVC (Figure 2).
case_images: The postoperative enhanced CT of the chest. The postoperative enhanced CT of the chest showed that the diameter of the left superior vena cava is 11 mm, and compare the inner diameters of the PLSVC with the superior vena cava to ensure that the PLSVC could function normally.
case_images: fsurg-10-1254937-g003.jpg
case_images: PMC10792061_01_fsurg-10-1254937-g003.jpg
case_images: F3
case_images: The subsequent postoperative enhanced CT demonstrated that the PLSVC could function normally within the SVC (Figure 3).