Transvenous removal of an entangled central venous line following complex cardiac surgery

Unintended internal suturing of central venous lines or pulmonary artery catheters in the superior caval vein or the right atrium following cardiac surgery remains a rare but troublesome complication. The line is normally entangled in safety or hemostasis sutures after the removal of the superior caval cannulation. If mild tension is unsuccessful, the patient normally undergoes resternotomy. The objective of this brief communication is to describe of a simple and safe removal method using a transvenous rotational cutting device to divide the hemostasis suture. In order to avoid complicating bleeding, a time delay between initial placement and removal is highly recommended. For extraction, a fully equipped cardiovascular operating room with central venous and arterial lines, attached defibrillator pads, transesophageal echo monitoring, fluoroscopy, and a surgical team, including a heart and lung machine and a perfusionist standby, is mandatory.