persistent left superior vena cava ( plsvc ) is a congenital but benign vascular anomaly   with a prevalence of 0.3 - 0.5% in the general population .
plsvc is one of the most common cardiovascular anomalies but is generally asymptomatic , and it is thus often identified accidentally during cardiovascular ultrasound / ct scan screening or coronary interventional angiography .
anatomically , plsvc causes the aberrant backflow vein to drain into the retrograde positioned coronary sinus .
some researchers have called attention to the risk of atresia of the coronary sinus among the anomalies associated with plsvc , but there are no recommendations regarding anticoagulation therapy for patients with plsvc .
nevertheless , coronary sinus atresia ( csa ) due to plsvc is a rare complication . in patients with hematological malignancies ,
the insertion of a central venous catheter ( cvc ) is required for the patient to undergo intensive chemotherapy .
hematologists must make a decision whether to conduct a cvc insertion for patients with a given complication .
there are a few reports of csa in plsvc induced by central venous catheterization , pacemaker wire placement , or cardiac surgery .
the placement of a cvc might evoke arrhythmia due to an additive enhancement of the patient 's arrhythmogenic condition .
considering such a situation , it may not be advisable to insert a cvc in a plsvc patient with a hematological malignancy .
we treated a 42-year - old male with stage iv hodgkin 's lymphoma with bone marrow involvement . the initial chemotherapy ( abvd , doxorubicin 25 mg / m , bleomycin 9 mg / m , vinblastine 6 mg / m , and dacarbazine 250 mg / m , day 1 and 15 ) was effective , resulting in complete remission after 6 cycles of abvd .
although the abvd chemotherapy had been administered via a peripheral vein , salvage chemotherapy was initiated via an implantable venous access port catheter because his peripheral blood accesses were ultimately unusable .
he received an indwelling port catheter from the left subclavian vein , since the right subclavian approach was not possible .
1a ) , which was found at the time for the first time in his life .
the patient successfully completed a total of 3 courses of salvage chemotherapy constructed with arac , carboplatin , etoposide , and methylpredonisolone ( aces ) .
although obstruction of the coronary venous drainage caused by plsvc has been suggested , it is not always thrombogenic .
a small plsvc flow can easily connect to hemostasis of the venous circulation return . in our patient ,
the plsvc cavity had enough space for a port catheter to be cannulated and positioned ( fig .
. ideally the back flow and diameter of the plsvc to the coronary sinus should be evaluated by cardiovascular ultrasound or cardiography .
although plsvc is a rare congenital anomaly , some risks including thrombosis and occlusion should be annotated when the patient receives a cvc insertion . the relationship between csa and plsvc remains unclear ; however , the hematologist should pay attention to the malpositioning of the cvc tip .
informed consent to participate in the study was obtained from the participant . written informed consent
was obtained from the patient for publication of this case series and any accompanying images .
a copy of the written consent is available for review by the editor - in - chief of this journal .
 persistent left superior vena cava is a congenital vascular anomaly , which is possibly arrhythmogenic and thrombogenic , rarely complicated with coronary sinus atresia . 
 we treated a 42-year - old male with hodgkin 's lymphoma requiring central venous catheter placement for intensive chemotherapy . 
 persistent left superior vena cava was revealed after the insertion of the central venous catheter by the radiological finding of the catheter tip cannulated into the vena cava cavity . 
 the relationship between coronary sinus atresia and persistent left superior vena cava induced by central venous catheterization remains unclear ; however , the hematologist should pay attention to the malpositioning of the central venous catheter . 