Hickman catheter-induced cardiac tamponade-related cardiac perforation management by mediastinotomy in children and a review of the literature

OBJECTIVE: Hickman catheter placement rarely causes cardiac tamponade due to cardiac perforation in children. Cardiac perforation can be managed with timely perceive and appropriate approach. We present a case of the cardiac perforation related to Hickman catheter insertion in a 7-year-old girl and a review of the supporting literature. CASE REPORT: The patient had previous history of Thalassemia and admitted to hospital for Hickman catheter placement for bone marrow transplantation. The catheter was placed in the right internal jugular vein by ultrasonography. During the postoperative period she had hypoxia, hypotension and tachycardia. The patient underwent an emergency surgery and there was a small perforation between vena cava superior and right atrium. That wound was managed by mediastinotomy. The patient was discharge on the 8th postoperative day. CONCLUSION: Cardiac perforation is one of the rare and unexpected complications of Hickman catheter placement. Unfortunately, the complication may cause significant mortality. The prompt diagnosis and early intervention provides satisfactory results.