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Delayed thrombosis of left internal jugular vein and left subclavian vein: complication related to drainage of left superior vena cava

Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India

^* Corresponding author. Tel.: +91-471-2443152; fax: +91-471-2446433/2550728
shri{at}sctimst.ker.nic.in

Objectives: To present a complication which occurred in relation to drainage of left superior vena cava. Methods: A 25-year-old patient underwent intracardiac repair for Tetralogy of Fallot. Left superior vena cava was present. It was drained by insertion of a left ventricular sump vent catheter via coronary sinus. The immediate postoperative period was uneventful. The patient presented on the 18th postoperative day with painful swelling on the left side of the neck, shoulder and upper arm. The patient was subjected to post-contrast CT scan and Duplex scan of neck vessels. He received anticoagulants for 3 months after the detection of thrombus in the left internal jugular vein and left subclavian vein. Results: Post-contrast CT scan and Duplex scan of neck vessels revealed organized thrombus in proximal portions of the left internal jugular vein and left subclavian vein, while the distal portions were free of thrombus and collateralized. Conclusions: The left internal jugular vein and left subclavian vein may get thrombosed due to drainage of left superior vena cava by a left ventricular sump vent catheter. Anticoagulants give immediate relief from symptoms and also prevent major thromboembolic complications.

Key Words: Superior vena cava; Thrombosis; Internal jugular vein; Vent