This case highlights the risk of fatal cardiac tamponade and ventricular perforation associated with silastic central venous catheters used for hypertonic parenteral nutrition.
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Heightened awareness of fatal tamponade risk with silastic catheters for hypertonic nutrition is warranted; leaves open true incidence and prevention strategies.
This is the first reported case of cardiac tamponade secondary to ventricular perforation involving a silastic catheter. The catheter had advanced into the right ventricle and become enmeshed in the trabeculae carnae. At autopsy there was an area of necrosis which we presumed was caused by the continuous direct contact of a small area of endocardium and subadjacent myocardium with the hypertonic infusate used for parenteral nutrition.
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Harford et al. (1984) studied this question.
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