Inadvertent Central Venous Catheter Placement into a Partial Anomalous Pulmonary Venous Connection: A Case Report

Aim and background: Central venous catheter (CVC) malposition is a known complication that may occasionally uncover congenital vascular anomalies.Partial anomalous pulmonary venous connection (PAPVC) is rare, especially on the left side, and may present diagnostic challenges when inadvertently cannulated.Case description: A 40-year-old male underwent left internal jugular CVC insertion postoperatively.Chest radiograph showed the catheter tip deviating leftward without crossing the midline.Ultrasound confirmed venous entry, while pressure waveform analysis demonstrated a venous pattern.Arterial blood gas sampling revealed paradoxically elevated PaO from the CVC compared with an arterial line.CT thoracoabdominal angiography confirmed malposition into a left-sided PAPVC draining into the brachiocephalic vein.The catheter was removed, and alternative venous access was secured without complications.Conclusion: CVC malposition into a PAPVC is rare but clinically significant, with risks of inappropriate drug delivery and pulmonary injury.Early recognition and catheter removal are critical to avoid complications and ensure patient safety.Clinical significance: A structured approach including ultrasound verification, waveform analysis, blood gas comparison, and advanced imaging is essential for diagnosis of PAPVC.