Insertion of a totally implantable venous access port in a patient with persistent left superior vena cava (PLSVC).

Persistent left superior vena cava (PLSVC) is a rare congenital variant, but it is the most common venous thoracic malformation, occurring in 0.3-0.5% of the general population. PLSVC is caused by the persistence of the embryological left anterior cardinal vein which normally obliterates and persists as the Marshall ligament. We present the case of a 74-year-old male lung cancer patient, who already underwent an uncomplicated right-hand sided pacemaker insertion in 2006. During implantation of a subcutaneous central venous access port through puncture of the left subclavian vein, a PLSVC was discovered. A venography and computed tomography confirmed the anomaly. The catheter of the central venous access port was positioned in the PLSVC with adequate drainage and flushing of blood, rendering it useful for administration of systemic chemotherapy. The patient underwent his chemotherapy cycles without major complications.