The study itself and the adjoining editorial2 both cite a lack of patient numbers to be able to fully bear out this finding. We would like to submit evidence further supporting this view. A prospective audit including 87 consecutive adult patients who had undergone elective cardiac surgery was performed. All patients received a triple-lumen catheter; in 93% of cases, the catheter was inserted in a right internal jugular vein. All catheter insertions were undertaken using the anterior approach without resorting to ultrasound guidance, and the catheter position was confirmed via blood flow, the easy flushing of all lumens, and the appropriate pressure waveform. The insertion of all lines was uncomplicated, they were sited either by a consultant or a specialist registrar, and follow-up chest radiographs were examined using the Patient Archive and Communication System. Following triple-lumen catheter insertion, 4.5% of patients were found to have a malpositioned central line, but this was of no clinical significance. Among those 81 patients who had undergone right internal jugular vein line insertion, 3 had the distal tip positioned in the right subclavian vein (3.7%). In these cases, deformity of the guidewire on its withdrawal was observed, and therefore incorrect positioning could have been predicted. Similar to the study by Lessnau,1 no episodes of pneumothorax were found.