A case in which a pulmonary artery catheter inserted via the right internal jugular vein became stuck and bent in the right subclavian vein.

  • Kodama Sahoko
    Department of Anesthesia, Akita University Hospital
  • Sato Koji
    Department of Anesthesia, Akita University Hospital
  • Nishikawa Toshiaki
    Department of Anesthesia and Intensive Care Medicine, Akita University Graduate School of Medicine

Bibliographic Information

Other Title
  • 右内頸静脈から挿入した肺動脈カテーテルが右鎖骨下静脈に迷入し屈曲したことにより抜去困難となった1症例
  • 症例報告 右内頸静脈から挿入した肺動脈カテーテルが右鎖骨下静脈に迷入し屈曲したことにより抜去困難となった1症例
  • ショウレイ ホウコク ミギ ナイ ケイ ジョウミャク カラ ソウニュウ シタ ハイ ドウミャク カテーテル ガ ミギ サコツ カ ジョウミャク ニ メイニュウシ クッキョク シタ コトニ ヨリ バツキョコンナン ト ナッタ 1 ショウレイ

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Description

<p> A 64-year-old man was scheduled for the removal of a left atrial myxoma. After tracheal intubation, we attempted to insert a pulmonary artery catheter (PAC) from the right internal jugular vein, but there was resistance after the PAC advanced 20 cm. When the PAC was pushed more strongly, the insertion successfully continued to 50 cm, but the right ventricular pressure could not be confirmed. We then pulled the PAC to remove it, but there was a strong resistance at about 40 cm. We performed chest radiography to confirm the location of the PAC, which revealed that the PAC entered from the right internal jugular vein into the right subclavian vein, thus it was bent in the axillary region, with the tip located in the superior vena cava. The PAC was subsequently pulled out of the operation field during cardiopulmonary bypass. Overall, to prevent the PAC from getting stuck, it should not be forcibly pushed during its insertion when resistance is encountered, and fluoroscopic guidance should be considered as an aid.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 23 (1), 115-119, 2019-08-01

    Japanese Society of Cardiovascular Anesthesiologists

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