Very rare malposition of central venous catheter in cardiac surgery patients. 2023

Nursen Tanrikulu, and Ali Haspolat, and Ali Sefik Koprulu
Department of Anesthesiology and Reanimation, Kolan International Hospital, Istanbul, Turkey. Email: nursentanrikulu1@gmail.com.

Malposition of a catheter is found in approximately 7% of cases after central venous catheterisation. This may result in haemorrhage, venous thrombosis and functional impairment, depending on the injury to the vessel wall. Uncomplicated catheterisation, easy aspiration of blood and monitoring of catheterisation do not guarantee correct placement of the catheter. In our rare case series, we share our experience of four cases of malposition into the left internal mammary vein (LIMV) that we experienced in a three-year period. The thinness and fragility of the vessel wall, particularly, increases the probability of complications in malposition into the LIMV. Administration of a catheter through the right jugular vein is associated with the lowest incidence of malposition. Performing the procedure under the guidance of ultrasonography (USG) and confirmation of the catheter position after puncture using one of the USG techniques will minimise the probability of malposition. In addition, a lung X-ray should immediately be taken, and venography and fluoroscopy should be considered in the presence of suspicion.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010690 Phlebography Radiographic visualization or recording of a vein after the injection of contrast medium. Venography,Phlebographies,Venographies
D002405 Catheterization, Central Venous Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein. Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D005260 Female Females
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D018084 Ultrasonography, Interventional The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions. Ultrasonography, Intravascular,Ultrasound, Interventional,Interventional Ultrasonography,Intravascular Ultrasonography,Interventional Ultrasound
D062905 Central Venous Catheters Catheters that are inserted into a large central vein such as a SUBCLAVIAN VEIN or FEMORAL VEIN. Central Venous Catheter,Catheter, Central Venous,Catheters, Central Venous,Venous Catheter, Central,Venous Catheters, Central

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