title: J-tip guide wire entrapment within the heart during central venous catheterization.
abstract: A 55-year-old female was hospitalized for melena. The patient was suspected of having uremia symptoms. Use of a tunneled cuffed hemodialysis catheter of the right internal jugular vein was planned. At one point, the wire could not be extracted or advanced. In addition, whenever the guide wire was manipulated, ventricular premature rhythms developed. Fluoroscopy revealed knotting of the guide wire in the right ventricle. A 7 French guiding catheter was inserted along the guide wire, which loosened the knotting of the guide wire. The present case shows that entrapment within the heart can develop due to use of a J-tip guide wire. If a guide wire cannot be removed despite several attempts with gentle pressure, this event should be ruled out by fluoroscopy and chest X-ray. Using of straight or curved guide wire and real-time surveillance using fluoroscopy or electrocardiography may be important to prevent this complication.
authors.affiliation: Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
authors.forename: Seok Hui
authors.initials: SH
authors.lastname: Kang
authors.forename: Won Kyu
authors.initials: WK
authors.lastname: Park
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Do
authors.forename: Kyu Hyang
authors.initials: KH
authors.lastname: Cho
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Yoon
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling; D004562:Electrocardiography / Q000295:instrumentation; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D007601:Jugular Veins; D008875:Middle Aged; D015641:Radiography, Interventional; D013902:Radiography, Thoracic / Q000295:instrumentation; D016896:Treatment Outcome