A central venous catheter was inadvertently placed into a pulmonary vein in a patient with undiagnosed partial anomalous pulmonary venous return. A post procedure chest X-ray revealed that the catheter tip was in the hilum of the left lung. A blood gas drawn from this misplaced catheter, a preexisting dialysis catheter and an arterial catheter showed different Po2 values of 167 mmHg, 26 mmHg and 98 mmHg respectively. This discrepancy supported our suspicion that the misplaced catheter tip was located in the left side of the heart. To rule out arterial placement we transduced the misplaced catheter. Both pressure and waveform showed venous characteristics, combined with Po2 of 167 mmHg supported the catheter tip being in the left side of the heart. A contrast computed tomography confirmed that the catheter was in the left upper pulmonary vein (fig. 1).
Pulmonary venous anatomy comprises of...
