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A Devastating Complication of Central Venous Catheter Insertion
Maryam Bahreini1, Alireza Jalali2, Atefeh Abdollahi1
1Sina Hospital, Tehran University of Medical Sciences Department of Emergency Medicine.
Journal of Acute Medicine
|September 30, 2020
Summary
A retained guidewire during central line placement led to infective endocarditis and lung emboli in a young man. This case highlights the critical need for careful technique during central venous catheterization to prevent serious complications.
Area of Science:
- Medicine
- Cardiology
- Infectious Diseases
Background:
- Central line placement is a common medical procedure.
- Retained guidewires are a known complication of central line insertion.
- Infective endocarditis is a serious infection of the heart valves.
Observation:
- A young man presented with fever, cough, and weakness.
- Chest radiography revealed lung lesions and a retained guidewire.
- Echocardiography showed large vegetations on the right heart valves.
Findings:
- The patient was diagnosed with infective endocarditis secondary to a retained guidewire.
- Multiple embolic lung lesions were present.
- Despite empirical antibiotics and guidewire removal, the patient's condition deteriorated.
Implications:
- This case underscores the importance of meticulous technique and supervision during central venous catheterization using the Seldinger technique.
- Preventable complications like retained guidewires can lead to severe outcomes, including infective endocarditis and mortality.
- Enhanced vigilance and skill are crucial to minimize risks associated with invasive procedures.
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