title: Catheter-malposition-induced cardiac tamponade via contrast media leakage during computed tomography study.
abstract: We present a rare case of a central venous catheter-malposition-induced life-threatening cardiac tamponade as a result of computed tomography (CT) with contrast enhancement in an infant with a ventricular septal defect and pulmonary atresia after a modified Blalock-Taussig shunt. The diagnosis was confirmed by chest radiographs and CT study with catheter perforation through the right atrial wall and extravasation of the contrast medium into the pericardium, leading to cardiac tamponade and subsequent circulatory collapse. Two hours after successful cardiopulmonary resuscitation, the patient gradually resumed normal hemodynamic status.
authors.affiliation: Department of Pediatric Cardiology and Radiology, Chang Gung Children's Hospital, Kaohsiung, Taiwan. cdliang@adm.cgmh.org.tw
authors.forename: Chi-Di
authors.initials: CD
authors.lastname: Liang
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Huang
authors.forename: Shao Ju
authors.initials: SJ
authors.lastname: Chien
authors.forename: Mao Meng
authors.initials: MM
authors.lastname: Tiao
mesh_terms: D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004837:Epinephrine / Q000008:administration & dosage; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007223:Infant; D007472:Iohexol / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D019300:Medical Errors / Q000009:adverse effects; D010496:Pericardium / Q000293:injuries*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D018633:Pulmonary Atresia / Q000601:surgery; D035583:Rare Diseases; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D007472:Iohexol; D004837:Epinephrine