Accidental suturing of jugular vein catheter in a mitral valve replacement

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“Accidental suturing of the catheter to the heart is a rare complication that is difficult to correct; excessive traction force on the central venous catheter can lead to heart breakage or even death.” Kong et al (2014).

Reference:

Kong, H.Y., Chen, S.S. and Wen, X.H. (2014) Suture of the right internal jugular vein catheter in a mitral valve replacement: a case report. Journal of Medical Case Reports. 8(1), p.129.

Abstract:

INTRODUCTION: Central venous catheterization can be necessary for patients undergoing a cardiac operation. Accidental suturing of the catheter to the heart is a rare complication that is difficult to correct; excessive traction force on the central venous catheter can lead to heart breakage or even death.

CASE PRESENTATION: We describe the case of a 56-year-old Han Chinese woman who was scheduled to undergo mitral valve replacement. The central venous catheter placed into her right internal jugular vein was accidentally sutured to the left atrial suture line during the operation. The stuck catheter was successfully removed without having to perform a cardiopulmonary bypass.

CONCLUSIONS: Attaching a catheter to the heart by cardiac sutures can occur when the tip of the catheter locates directly above the atrial-caval junction. Care should be taken when closing the cephalad end of a left atrial incision in a mitral valve replacement. Although rare, accidental suturing of the central venous catheter must be kept in mind, and an approach should be chosen to remove the catheter that best avoids additional insult to the heart function.

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