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Cardiac tamponade complicating percutaneous catheterization of subclavian vein
Insights
Cardiac tamponade from central venous pressure (CVP) monitoring catheters is a rare complication. Prompt recognition and fluid infusion via the CVP catheter may prevent invasive surgery.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Complications
Background:
- Central venous pressure (CVP) monitoring is crucial for hemodynamic assessment.
- Percutaneous subclavian vein catheterization is a common CVP access route.
- Complications, though rare, require thorough understanding.
Purpose of the Study:
- To report a previously undocumented complication of CVP monitoring.
- To highlight cardiac tamponade resulting from subclavian vein catheter perforation.
- To propose a less invasive diagnostic and therapeutic approach.
Main Methods:
- A case report detailing a patient experiencing cardiac tamponade.
- Review of the clinical presentation and management of the complication.
- Discussion of the proposed alternative diagnostic/therapeutic method.
Main Results:
- A patient developed cardiac tamponade due to a CVP catheter perforating the subclavian vein and entering the mediastinum.
- Fluid infusion through the misplaced catheter exacerbated cardiac compression.
- Successful treatment was achieved via thoracotomy.
Conclusions:
- Cardiac tamponade is a potential, albeit rare, complication of subclavian CVP catheterization.
- Infusion of radiopaque dye through the CVP catheter may aid in early diagnosis and non-surgical correction.
- This approach could potentially avoid the need for thoracotomy in similar cases.
Abstract:
Cardiac tamponade has not been reported previously as a complication of central venous pressure (CVP) monitoring catheters inserted via the percutaneous subclavian vein approach. In one patient perforation of the vein by the catheter resulted in the catheter lying free in the mediastinum. Deterioration of the patient prompeted increasing infusion of fluids through this catheter with incresing cardiac compression. Relief was obtained after a thoracotomy. Ti is suggested that this complication may be recognized in the future and corrected without thoracotomy if radiopaque dye is infused through the CVP catheter.