title: Breast necrosis secondary to vasopressor extravasation: management using indocyanine green angiography and omental flap closure.
abstract: Extravasation is a rare but serious complication of vasopressor administration. A 60-year-old female who underwent ascending and hemiarch repair of the aorta along with aortic valve replacement developed extensive right breast and chest wall necrosis after vasopressor extravasation from an internal jugular vein central line. The patient underwent a total mastectomy due to deep tissue necrosis detected by laser-assisted indocyanine green dye angiography, and eventually required omental flap reconstruction to obtain adequate sternal coverage. This case represents a previously unreported complication of internal jugular central line extravasation of vasopressors with resultant breast and chest wall necrosis, and highlights the utility of the omentum in chest wall reconstruction.
authors: Division of Plastic Surgery, Emory University School of Medicine, Atlanta, Georgia.
authors: Thomas M
authors: TM
authors: Hagopian
authors: Paul A
authors: PA
authors: Ghareeb
authors: Brian H
authors: BH
authors: Arslanian
authors: Benjamin L
authors: BL
authors: Moosavi
authors: Grant W
authors: GW
authors: Carlson
mesh_terms: D000792:Angiography / Q000379:methods; D001940:Breast / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced; D013524:Surgical Flaps; D014662:Vasoconstrictor Agents / Q000009:adverse effects*; D014667:Vasopressins / Q000009:adverse effects*
chemical_list: D004396:Coloring Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D007208:Indocyanine Green
keywords: chest wall reconstruction; extravasation; indocyanine green angiography; omental flap