Left subclavian canulation in a newborn with right sided congenital diaphragmatic hernia: A case report.

Venous cannulation can be challenging in newborns, especially those under 3 kg or presenting with vascular malformations. Left subclavian vein cannulation is an alternative site described in adults and infants. We report the first neonatal case of left subclavian cannulation as a last-resort venous access in a newborn presenting with a right-sided congenital diaphragmatic hernia associated with right internal jugular vein malformation. The patient required extracorporeal membrane oxygenation (ECMO) support in the context of refractory septic shock at day 6 of life. ECMO was weaned after 16 days, and cannula was removed without bleeding complications. This alternative venous access may be a viable option for venous cannulation in cases where the right jugular vein is unavailable.