Year : 2018  |  Volume : 12  |  Issue : 1  |  Page : 118-120

Nonfatal cardiac perforation after central venous catheter insertion

1 Department for Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
2 Cardiovascular Diseases, University Hospital Centre, Zagreb, Croatia

Correspondence Address:
Dr. Vedran Premuzic
12, Kispaticeva Street, Zagreb 10000
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.SJA_365_17

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Cardiac tamponade caused by perforation of the cardiac wall is a rare complication related to central venous catheter (CVC) placement. A 71-year-old female with a previous history of moderate aortic stenosis and kidney transplantation was admitted to hospital due to global heart failure and worsening of allograft function. Intensified hemodialysis was commenced through a CVC placed in the right subclavian vein. Chest radiography revealed catheter tip in the right atrium and no signs of pneumothorax. Thorough diagnostics outruled immediate life-threatening conditions, such as myocardial infarction and pulmonary embolism. However, not previously seen, 2 cm thick pericardial effusion without repercussion on the blood flow was visualized during echocardiography, predominantly reclining the free surface of the right atrium, with fibrin scar tissue covering the epicardium – it was the spot of spontaneously recovered cardiac wall perforation. Follow-up echocardiogram performed before the discharge showed regression of the previously found pericardial effusion.

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