Fatal perforation of the right ventricular wall and pericardiac sac without presence of pericardiac tamponade by a central venous catheter is reported. The various events leading eventually to this catastrophic complication, such as malpositioning of the catheter tip, and its migration with the patient movements, are discussed. More frequent radiologic checks of the catheter tip, the use of silicon rubber catheters, and restriction of the patient's movements are recommended to avoid this fatal complication.
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References
1.
Ryan JA, Abel RM, Abbot WM, et al: Catheter complication in total parenteral nutrition. N Engl J Med290:757-61, 1974
2.
Christensen KH , Nerstrom B., Baden A.: Complication of percutaneous catheterization of the subclavian vein in 129 cases. Acta Chir Scand133:615-620, 1967
3.
Kuiper DH: Cardiac tamponade and death in a patient receiving total parenteral nutrition . JAMA230:877, 1974
4.
Herbst CA: Indication, management and complications of percutaneous subclavian catheters . Arch Surg113:1421-1425, 1978
5.
Padberg FT, Ruggiero J.Blackburn GL, et al: Central venous catheterization for parenteral nutrition. Ann Surg193:264-270, 1981
6.
Brandt RLFoley WJ, Fink GH, et al: Mechanism of perforation of the heart with production of hydropericardium by a venous catheter and its prevention. Am J Surg119:311-316, 1970
7.
Raffensperger JGRamenofsky ML: A fatal complication of hyperalimentation: a case report. Surgery68:393-394, 1970
8.
Friedman BA, Jurgeliet HC: Perforation of atrium by polyethylene CV catheter. JAMA203:1141-1142, 1968
9.
Thomas CS, Carter JW, Lowder SC: Pericardial tamponade from central venous catheters. Arch Surg98:217-218, 1969
10.
Geis WP, Johnson CF, Zajichuk R., et al: Extrapericardial (mediastinal) cardiac tamponade. Arch Surg100:305-306, 1970
11.
Kline KI, Hofman WI: Cardiac tamponade from CVP catheter perforation. JAMA206:1793-1794, 1968
