A CVL is a long, soft plastic tube (usually made of silicone) that is placed via a small cut in the neck, chest, or groin into a large vein in the chest to allow IV fluids and medications to be given.

WHY IS A CVL USED?

The primary reason for a CVL is to allow for IV nutrition to be given over a long period of time. Most often, a surgically placed CVL is used when attempts to place a Percutaneous Inserted Central Catheter (PICC) have failed.

Infants most likely to need a CVL are those with bowel problems likely to prevent adequate feeding via the gut for a long time, and infants who require a very long course of IV medication.

HOW IS A CVL PLACED?

All CVLs are placed using sterile techniques similar to an operation. This may be done in the NICU or in the operating room. Pain medication is used to minimize discomfort. A small incision is made in the skin away from the vein to be entered. A small metal probe is used to create a narrow tunnel under the skin. The catheter is inserted through the tunnel, into a vein and advanced to a position near the heart. The position of the CVL is determined by an x-ray.

WHAT ARE THE RISKS OF A CVL?

As with any form of IV the use of a CVL carries a small risk of infection. The longer the CVL is in place the greater the risk for infection. Formation of blood clots in the large veins leading to the heart can also occur. If infection or blood clots form due to the CVL, it may need to be removed and other therapies given. You should talk with your doctor.

Though the catheters are very soft and flexible, at times they can erode through the blood vessel wall causing the IV fluid or medication to leak into the tissue or body cavity. In very rare instances, erosion through a wall of the heart can occur and cause serious bleeding and poor heart function.