Persistent left superior vena cava: A possible contraindication to chemotherapy and total parenteral nutrition in cancer patients

Iovino,Francesco; Auriemma,Pasquale   Pio; Del Viscovo,Luca; Scagliarini,Sara; Di Napoli,Marilena; De Vita,Ferdinando

doi:10.3892/ol.2012.808

October 2012 Volume 4 Issue 4

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October 2012 Volume 4 Issue 4

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Article

Persistent left superior vena cava: A possible contraindication to chemotherapy and total parenteral nutrition in cancer patients

Authors:
- Francesco Iovino
- Pasquale Pio Auriemma
- Luca Del Viscovo
- Sara Scagliarini
- Marilena Di Napoli
- Ferdinando De Vita
View Affiliations / Copyright

Affiliations: Division of General Surgery, Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy, Division of Radiology, ‘F. Magrassi - A. Lanzara’, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy, Division of Medical Oncology, ‘F. Magrassi - A. Lanzara’, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
Pages: 759-762
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Published online on: July 18, 2012

https://doi.org/10.3892/ol.2012.808
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Abstract

Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. Awareness of this condition may be useful when placement of left-side transvenous subclavian or internal jugular catheters is required. This anomaly may be detected only by chest radiograph following placement of the catheter. The primary endpoints of this study were to analyze the prevalence of PLSVC, measurement of its diameters and the outcome of cancer patients with this anomaly undergoing placement of a long term catheter for nutrition and chemotherapy at the Department of Surgery, of the Second University of Naples, Naples, Italy. A total of 600 consecutive adult patients with hematological or solid tumors admitted to our surgery department for implantation of a central venous catheter (CVC) were considered. The CVC was routinely implanted in the left internal jugular vein under ultrasound guidance. Four cases of PLSVC (0.6% of patients) were observed and confirmed using cine magnetic resonance imaging (MRI). In all cases, the CVC was not removed. Three patients underwent chemotherapy and one patient was subjected to total parenteral nutrition. In the three patients undergoing chemotherapy, dynamic ECG and echocardiography were performed at the end of the treatment. No disturbances of the cardiac rhythm or thrombosis were detected, and heart ejection fraction (EF) was not affected. In conclusion, although PLSVC may be a risky condition, no complications occurred in our study. Thus, PLSVC should not be regarded as a strict contraindication to infusion of chemotherapy or hyperosmolar nutritional solutions. However, further research is needed to confirm our data.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Persistent left superior vena cava: A possible contraindication to chemotherapy and total parenteral nutrition in cancer patients

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