Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9879-9885
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9879
Accidental venous port placement via the persistent left superior vena cava: Two case reports
Rui-Na Zhou, Xiao-Bin Ma, Li Wang, Hua-Feng Kang
Rui-Na Zhou, Xiao-Bin Ma, Li Wang, Hua-Feng Kang, Department of Oncology, The Second Affiliated Hospital of Xi’an Jiao Tong University, Xi'an 710004, Shaanxi Province, China
Author contributions: Ma XB contributed to the conception of the study; Wang L contributed significantly to analysis and manuscript preparation; Zhou RN performed the data analyses and wrote the manuscript; Kang HF helped perform the analysis with constructive discussions.
Supported by Key Research and Development Projects of Shaanxi Province, No. 2019SF-064.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua-Feng Kang, MD, Professor, Department of Oncology, The Second Affiliated Hospital of Xi’an Jiao Tong University, No. 157 West Fifth Road, Xi'an 710004, Shaanxi Province, China. kanghuafeng1973@126.com
Received: May 12, 2022
Peer-review started: May 12, 2022
First decision: July 14, 2022
Revised: July 27, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 26, 2022
Processing time: 127 Days and 5.9 Hours
Abstract
BACKGROUND

Breast cancer poses a great threat to females worldwide. There are various therapies available to cure this common disease, such as surgery, chemotherapy, radiotherapy, and immunotherapy. Implantable venous access ports (IVAP, referred to as PORT) have been widely used for breast cancer chemotherapy. Venous malformations are possible conditions encountered during PORT implantation. Persistent left superior vena cava (PLSVC) is a common superior vena cava malformation. Most patients have normal right superior vena cava without affecting hemodynamics, so patients often have no obvious symptoms.

CASE SUMMARY

We incidentally found that two patients had PLSVC while a PORT was implanted via the internal jugular vein. Due to chemotherapy for breast cancer, PORT was successfully implanted under the guidance of ultrasound into these 2 patients. Positive chest X-ray examination after the operation showed that the catheter ran beside the left mediastinum and the end was located in the seventh thoracic vertebra. The patients had no catheter-related complications and successfully completed the course of chemotherapy. Ultrasonography found that the ratio of PORT outer diameter to PLSVC inner diameter was less than 0.45, which was in line with the recommendations of relevant literature and operating guidelines. The purpose of this article is to introduce two rare cases and review the relevant literature.

CONCLUSION

Correct assessment of PLSVC status and ultrasound-guided PORT placement generally does not affect breast cancer patients chemotherapy.

Keywords: Implantable venous access port; Persistent left superior vena cava; Chemotherapy; Coronary sinus; Case report

Core Tip: We accidentally discovered two cases of implantable venous access ports (IVAP, referred to as PORT) placement through the persistent left superior vena cava (PLSVC). Both patients had no obvious clinical symptoms, and the operation was smooth and the postoperative recovery was good. According to relevant literature and operation guideline, the PORT should only be placed if the ratio of the PORT outer diameter to the PLSVC inner diameter is less than 0.45, otherwise catheter-related complications may occur. At the same time, it is recommended that all patients undergo ultrasonography before venous port placement to determine whether the coronary sinus is dilated.