Videothoracoscopic-guided management of a central vein perforation during hemodialysis catheter placement.
We present a case of the successful repair of an iatrogenic central vein lesion using a videothoracoscopic approach. The confluence of the right innominate vein and the superior vena cava was perforated during the placement of a right internal jugular vein long-term dialysis catheter. The misplacement of the tips of the catheter in the right pleural space was promptly observed. The catheter was removed under pleural videothoracoscopic vision while a tamponade was directly applied to the mediastinal perforation. Massive bleeding was prevented and the central vein perforation was treated successfully using a minimally invasive technique.
Kuzniec
Sérgio
S
Department of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil. kuzniec@terra.com.br
Natal
Sílvia Regina Bottini
SR
Werebe
Eduardo de Campos
Ede C
Wolosker
Nelson
N
D016121:Brachiocephalic Veins / Q000293:injuries / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000150:complications / Q000628:therapy; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000209:etiology / Q000628:therapy; D012421:Rupture; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000293:injuries / Q000601:surgery*; D014950:Wounds, Penetrating / Q000209:etiology / Q000601:surgery*