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For trans-subclavian smart cannulation of the right atrium: What to do if the guide wire cannot be identified with echocardiography?

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For trans-subclavian smart cannulation of the right atrium: What to do if the guide wire cannot be identified with echocardiography?

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One possibility is that the guide wire progresses cranially. A curved catheter pointing caudally may allow for exploration of the superior vena cava with a J-type guide wire.

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