title: Unusual positioning of a central venous catheter.
abstract: Central venous cannulation, with or without a flow-directed pulmonary artery catheter, is commonly performed in patients undergoing cardiac surgery to measure central filling pressure and cardiac output, and to administer medications and fluids. The complications of central venous cannulation are numerous and include malposition, arterial puncture, pneumothorax, hemothorax, chylothorax, extravasation of infusate, thrombophlebitis, and infection. We describe a single-lumen catheter that was placed through the hemostatic valve of a 9F percutaneous introducer, which inadvertently entered the left internal mammary (internal thoracic) vein. The current case is unique in that it was diagnosed by visualization of the catheter during surgical dissection.
authors.affiliation: Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Kanter
authors.forename: Neil Roy
authors.initials: NR
authors.lastname: Connelly
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002496:Central Venous Pressure; D006801:Humans; D007601:Jugular Veins; D008297:Male