Case study: Seldinger guide wire-induced cardiac perforation (full text)


Intravenous literature: Hiroshima, Y., Tajima, K., Shiono, Y., Suzuki, I., Kohno, K., Kato, Y., Shunji, K. and Kato, T. (2012) Soft J-tipped Guide Wire-induced Cardiac Perforation in a Patient with Right Ventricular Lipomatosis and Wall Thinning. Internal Medicine. 51(18), p.2609-12.

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Cardiac tamponade caused by perforation is a rare but potentially lethal complication of central venous catheter (CVC) insertion. We herein report a case of cardiac perforation associated with the use of a soft J-tipped guide wire. Twenty minutes after the insertion of a CVC, the patient developed unexpected cardiac arrest. An autopsy revealed 400 mL of pericardial blood. The right ventricular wall was 1 mm thick with about 10 myocyte layers, which is one-third that of the normal heart. A histological analysis revealed widespread fatty infiltration of the right ventricular wall (right ventricular lipomatosis).

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