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Left ventricular perforation with catheter decompression.

Janice Shin-Kim1, Nathan Zapolsky2, Elias Wan3

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Summary
This summary is machine-generated.

Thoracostomy tube placement is common, but rare complications can occur. This case details a thoracostomy tube mistakenly placed in the left ventricle, successfully managed with thoracotomy.

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Area of Science:

  • Emergency Medicine
  • Cardiothoracic Surgery
  • Medical Device Complications

Background:

  • Thoracostomy tube placement is a frequent emergency department procedure for pneumothorax, hemothorax, empyema, or pleural effusion.
  • Complication rates for thoracostomy range from 19.4-37%, with extrathoracic placement being most common.
  • Recent meta-analyses indicate a stable complication rate of approximately 19% over three decades, predominantly benign.

Observation:

  • A rare complication involving a small-caliber thoracostomy tube placed within the left ventricle is presented.
  • The misplacement occurred during a standard thoracostomy procedure.

Findings:

  • Surgical thoracotomy was required for the removal of the misplaced thoracostomy tube from the left ventricle.
  • Despite the rare and potentially severe complication, the patient experienced a virtually asymptomatic and uneventful recovery.

Implications:

  • This case highlights the importance of vigilance and awareness of rare but serious complications during thoracostomy tube placement.
  • Accurate procedural technique and prompt recognition of malposition are crucial for patient safety.
  • Successful management of this rare complication underscores the efficacy of timely surgical intervention.