Pediatric central venous catheterization

The aortic valve (AV) has been used as a surrogate marker for the superior vena cava‐right atrium (SVC‐RA) junction during the placement of central venous catheters. There is a paucity of evidence to determine whether this is a consistent finding in children. Eighty‐seven computed tomography scans of the thorax acquired at local children's hospitals from April 2010 to September 2011 were retrospectively collected. The distance between the SVC‐RA junction and the AV was measured by dual consensus. The cranio‐caudal level of the junction and the AV were referenced to the costal cartilages (CCs) and anterior intercostal spaces (ICSs). The results confirmed that the SVC‐RA junction has a variable relationship to the AV. The junction was on average 3.1 mm superior to the AV. This distance increased with age. In the 7 years old age group: 4 mm (range: −11 to 16 mm). The surface anatomy of the SVC‐RA junction was variable, ranging from the second ICS to sixth CC. The SVC‐RA junction has a predictable relationship to the AV, and this can be used as an adjunct marker for accurate placement of central venous catheters except in the smallest neonates. Clin. Anat. 32:778–782, 2019. © 2019 Wiley Periodicals, Inc.