Anomalous Pulmonary Vein Drainage Into the Innominate Vein Diagnosed After Central Line Placement: A Case Report Along With a Review of Rare Congenital Anatomy Partial Anomalous Pulmonary Venous Return

Abstract

Anomalous pulmonary vein drainage is a rare but clinically relevant variant of the cardiovascular anatomy. We present a case report of a 22-year-old male who was incidentally found to have anomalous pulmonary vein drainage into the innominate vein. The patient had a known history of seizures and was brought to the emergency department following a simple tonic-clonic seizure. He was subsequently intubated for airway protection and admitted to the medical intensive care unit (MICU). While in the MICU, a left internal jugular central venous catheter (CVC) was placed; however, post-procedural chest radiography showed the tip of the CVC in the left chest. An arterial blood gas (ABG) was concerning for arterial blood. Due to the uncertainty of line positioning, a computed tomography pulmonary angiography revealed a rare abnormal connection between the left innominate vein and the left pulmonary vein. This case underscores the importance of potential variations in pulmonary venous drainage as they may have implications for post-procedural decision-making and potentially clinical outcomes.