Nonfatal cardiac perforation after central venous catheter insertion

Premuzic, V., Katalinic, L., Pasalic, M. and Jurin, H. (2018) Nonfatal cardiac perforation after central venous catheter insertion. Saudi Journal of Anaesthesia. 12(1), p.118-120.

doi: 10.4103/sja.SJA_365_17

Cardiac tamponade caused by perforation of the cardiac wall is a rare complication related to central venous catheter (CVC) placement. A 71-year-old female with a previous history of moderate aortic stenosis and kidney transplantation was admitted to hospital due to global heart failure and worsening of allograft function.

Intensified hemodialysis was commenced through a CVC placed in the right subclavian vein. Chest radiography revealed catheter tip in the right atrium and no signs of pneumothorax. Thorough diagnostics outruled immediate life-threatening conditions, such as myocardial infarction and pulmonary embolism. However, not previously seen, 2 cm thick pericardial effusion without repercussion on the blood flow was visualized during echocardiography, predominantly reclining the free surface of the right atrium, with fibrin scar tissue covering the epicardium – it was the spot of spontaneously recovered cardiac wall perforation. Follow-up echocardiogram performed before the discharge showed regression of the previously found pericardial effusion.

Posted by IV Team Feb 13, 2018


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