[Central venous catheterization complication by a guide wire].

Area of Science:

• Cardiology
• Interventional Radiology
• Medical Device Engineering

Background:

• Central venous catheterization via the Seldinger technique is common.
• Complications from needle puncture and indwelling catheters are well-documented.
• Guide wire entanglement near the tricuspid valve is an infrequent but serious complication.

Observation:

• A case of guide wire entanglement with the tricuspid valve chordae tendineae during internal jugular vein catheterization is presented.
• Resistance was encountered during guide wire removal, with imaging confirming its location in the right ventricle.
• The guide wire tip was found to be excessively bent, though the cause remained unclear.

Findings:

• Successful retrieval of the entrapped guide wire was achieved by advancing the central venous catheter to its tip.
• This case highlights a rare complication of central venous catheterization.
• The study emphasizes the importance of investigating the cause of resistance rather than blindly withdrawing the guide wire.

Implications:

• Clinicians should be aware of the potential for guide wire entanglement during central venous catheterization.
• Prompt and appropriate intervention, such as advancing the catheter, can resolve this complication.
• Further investigation into guide wire material and technique may help prevent such incidents.