Persistent left superior vena cava and ipsilateral intraventricular hemorrhage in a preterm infant

We describe a preterm infant with a peripherally inserted central catheter (PICC) placement. The PICC line was suspected to be in the persistent left superior vena cava (PLSVC), confirmed by echocardiogram. PLSVC is a rare anomaly. On routine screening, the infant was noted to have an ipsilateral intraventricular hemorrhage (IVH) postulated to be secondary to the altered retrograde blood flow through the PLSVC. No such association has been reported previously. The case presentation is followed by evidence supporting the postulated mechanism. Although the association between PLSVC and IVH could be coincidental, clinicians should be aware of the blood flow-related problem associated with PLSVC in preterm infants.