Optimizing the tip position of a peripherally inserted central venous catheter under a multidisciplinary team approach in a patient with mirror-image dextrocardia: a case report

Abstract

Peripherally inserted central venous catheters (PICCs) are widely used in cardiology because they are convenient, effective, and safe. However, PICC implantation in patients with mirror-image dextrocardia who have thoracic tumors has not yet been reported. In this case report, we describe a 46-year-old patient with lung cancer who had a thoracic inclination and left pulmonary artery compression of the superior vena cava. PICC implantation under B-ultrasound guidance was planned. Because of the anatomical differences caused by mirror-image dextrocardia, we investigated the optimal position and measurement method for the tip of the PICC according to the compression site of the vascular lumen through a multidisciplinary team approach. Electrocardiography-assisted tip positioning combined with postoperative chest X-ray positioning was performed for accurate positioning.