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Published on: February 14, 2022

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

Dongmin Kim1, Seong-Hoon Lim, Pil Won Seo

  • 1Department of Internal Medicine, Dankook University College of Medicine, Korea.

The Korean Journal of Thoracic and Cardiovascular Surgery
|June 18, 2013
PubMed

Insights

Chest drain insertion for pleural effusion can rarely cause heart perforation. This case highlights a left ventricle perforation, successfully treated with mini-thoracotomy, emphasizing prompt diagnosis of this rare complication.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Chest drain insertion is a standard procedure for managing pleural effusion.
  • Cardiac perforation is a rare but potentially fatal complication associated with chest drain placement.
  • Congestive heart failure can present with symptoms mimicking pleural effusion.

Observation:

  • A 76-year-old female with congestive heart failure presented with unilateral chest opacity suggestive of massive pleural effusion.
  • A chest drain was inserted into the left pleural space.
  • Pulsatile bleeding from the drain prompted suspicion of malposition and cardiac injury.

Findings:

  • Computed tomography confirmed perforation of the left ventricle.
  • The malpositioned chest drain had perforated the heart.
  • Successful extraction of the drain via mini-thoracotomy was performed.

Implications:

  • This case underscores the importance of considering cardiac injury in patients with pulsatile bleeding during chest drain insertion.
  • Prompt diagnostic imaging and surgical intervention are crucial for managing this rare complication.
  • Awareness of this risk is vital for clinicians performing or overseeing chest drain procedures.

Keywords:
Chest tubesComplicationsHeart

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