Central Catheter-Induced Cardiac Tamponade in Neonates: Two Case Reports

Intraoperative central venous catheter (CVC) insertion has become a routine procedure for pediatric cardiac surgery patients at our center. The case in which large amounts of pericardial effusion resulting in cardiac tamponade other than direct puncture of the catheter is a rare, but often causes fatal complications. Two of our patients suffered cardiac collapse after surgery owing to cardiac tamponade. Both the patients were successfully treated with pericardiocentesis, and the pericardial fluid had a high glucose level. Subsequently, the patients were discharged without any sequelae. During a serial radiographic follow-up, we found a pre-event alteration in the CVC angulation. These two cases highlight the fact that clinicians should pay attention to serial follow-up of chest radiography for monitoring any changes in the catheter status, such as its position or angulation, to prevent unexpected complications. The only way to prevent fatal complications due to CVC is timely recognition of any alteration in CVC based on radiological examinations. In instances of CVC changes, the issues should be addressed as quickly as possible.