Good and bad luck together: A cardiac tamponade case subsequent to internal jugular vein catheterization

Şans ve şanssızlık bir arada: İnternal juguler ven kateterizasyonu sonrasında ortaya çıkan kalp tamponadı olgusu

Özet

Santral venöz kateterizasyonu (SVK) büyük cerrahi girişimler öncesinde; venöz yol ve hemodinamik izlem sağlamak ve ilaç planlaması yapmak gibi amaçlarla uygulanmaktadır. Kateterizasyon sonrasında nadir de olsa ciddi komplikasyonlar gelişebilmektedir. Koroner bypass cerrahisi planlanarak ameliyata hazırlanan 72 yaşında kadın hastaya, sağ internal juguler venden SVK yapıldı. Sternotomiyi takiben gelişen bradikardi üzerine acilen perikard açıldı ve hemoperikardiyum geliştiği gözlendi. Cerrahi ekip tarafından santral kateterin ucu vena kava süperiyor üzerinde görüldü ve geri itildi. Kanülasyonlar hızla tamamlanarak pompaya girildi, vena kava tamiri ve cerrahi işlem tamamlanarak olgu yoğun bakıma nakledildi. Bu makalede SVK’nin nadir fakat potansiyel olarak ölümcül bir komplikasyonu olan kardiyak tamponad olgusu sunuldu.

Abstract

Prior to serious surgical interventions, central venous catheterization (CVC) is used with such purposes as obtaining venous tract and hemodynamic monitorization as well as applying medicine. Although it is rare, serious complications might develop after catheterization. A 72-year-old female patient who was being prepared for coronary bypass surgery was inserted a CVC into right internal jugular vein. Her pericardium was opened upon the bradycardia that developed following the sternotomy, and it was observed that hemopericardium had developed. The tip of the central catheter was seen on vena cava superior and was pushed back by the surgery team. Cannulations were completed quickly and the pump was entered, vena cava was repaired and surgery was completed and then the patient was transferred to intensive care unit. In this article cardiac tamponade, which is a rare but potentially fatal complication associated with CVC, has been presented.