Persistent left superior vena cava detected during central venous catheterization for continuous renal replacement therapy in acute kidney injury: A case report

Abstract

Persistent left superior vena cava (PLSVC) is an uncommon anatomical anomaly of the venous system with a prevalence of approximately 0.3%-0.5% in the general population and a higher incidence in patients with congenital heart disease. This condition is usually asymptomatic and often discovered incidentally during imaging studies or cardiovascular procedures. However, PLSVC may pose challenges or lead to complications in certain interventions, such as central venous catheter insertion, permanent pacemaker implantation, or cardiac surgery. This case report and review of the literature concerns a patient with a history of scrub typhus complicated by pulmonary hemorrhage and acute kidney injury, who required insertion of a double-lumen catheter and continuous renal replacement therapy. During catheter placement, a PLSVC was incidentally identified, highlighting a rare but clinically relevant finding. This report underscores the importance of PLSVC awareness in critically ill patients, as its presence may have implications for treatment planning, procedural safety, and the prevention of potential complications.