Clinical Presentation

A 41-year-old man presents for placement of a central line for dialysis.

(A) Frontal radiograph shows central line along the left mediastinum (arrow). The line was not functioning. (B) Venogram from a new right jugular line shows a left-sided superior vena cava (SVC: arrow) with anomalous drainage into the coronary sinus (arrowhead). (C) Coronal reformatted contrast-enhanced computed tomographic (CT) scan shows patent right SVC (arrow). (D) More posterior slice shows persistent left SVC (arrow).

Differential Diagnosis