title: Transvenous removal of an entangled central venous line following complex cardiac surgery.
abstract: Unintended internal suturing of central venous lines or pulmonary artery catheters in the superior caval vein or the right atrium following cardiac surgery remains a rare but troublesome complication. The line is normally entangled in safety or hemostasis sutures after the removal of the superior caval cannulation. If mild tension is unsuccessful, the patient normally undergoes resternotomy. The objective of this brief communication is to describe of a simple and safe removal method using a transvenous rotational cutting device to divide the hemostasis suture. In order to avoid complicating bleeding, a time delay between initial placement and removal is highly recommended. For extraction, a fully equipped cardiovascular operating room with central venous and arterial lines, attached defibrillator pads, transesophageal echo monitoring, fluoroscopy, and a surgical team, including a heart and lung machine and a perfusionist standby, is mandatory.
authors: Department of Thoracic and Cardiovascular Surgery, University Hospital Tuebingen, Tuebingen, Germany.
authors: Ke
authors: K
authors: Sun
authors: Hermann
authors: H
authors: Aebert
authors: Ulrich A
authors: UA
authors: Stock
authors: Milan
authors: M
authors: Lisy
authors: Gerhard
authors: G
authors: Ziemer
authors: Volker
authors: V
authors: Doernberger
mesh_terms: D000368:Aged; D013504:Cardiovascular Surgical Procedures; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans