title: Migration of a Central Venous Catheter in a Hemodialysis Patient Resulted in Left Atrial Perforation and Thrombus Formation Requiring Open Heart Surgery.
abstract: Central venous catheterization is widely used in patients on hemodialysis. A rare complication associated with the clinical use of central venous catheters is perforation of the heart or major vessels. We report a case of inadvertent perforation of the left atrium and thrombosis after the placement of a hemodialysis catheter in the right internal jugular vein. In such cases, surgical removal of the central venous catheter from perforation sites in the heart and vessel walls poses anesthetic challenges because of the high risk of pneumothorax, hemorrhage, arrhythmias, thrombosis, and death.
authors.affiliation: From the *Division of Anesthesiology, Geisinger Medical Center, Danville, Pennsylvania; and †Division of Cardiology, Geisinger Medical Center, Danville, Pennsylvania.
authors.forename: Kevin
authors.initials: K
authors.lastname: Wong
authors.forename: Barry A
authors.initials: BA
authors.lastname: Marks
authors.forename: Anwer
authors.initials: A
authors.lastname: Qureshi
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Stemm
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006325:Heart Atria / Q000293:injuries / Q000601:surgery*; D006801:Humans; D006435:Renal Dialysis; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*