Key result
Soft J-tipped guide wire insertion causes fatal cardiac perforation in severe right ventricular lipomatosis.
Why the study?
Cardiac tamponade caused by perforation is a rare but potentially lethal complication of central venous catheter insertion, with limited data on risks related to soft J-tipped guide wires in patients with right ventricular lipomatosis and wall thinning.
Case Report (n=1)
Highlights the rare but lethal risk of cardiac perforation from soft J-tipped guide wires during CVC insertion in patients with underlying right ventricular wall thinning and lipomatosis.
Fatal perforation during subclavian CVC in RV lipomatosis warrants vigilance; single case leaves open incidence and prevention strategies.
Cardiac tamponade caused by perforation is a rare but potentially lethal complication of central venous catheter (CVC) insertion. We herein report a case of cardiac perforation associated with the use of a soft J-tipped guide wire. Twenty minutes after the insertion of a CVC, the patient developed unexpected cardiac arrest. An autopsy revealed 400 mL of pericardial blood. The right ventricular wall was 1 mm thick with about 10 myocyte layers, which is one-third that of the normal heart. A histological analysis revealed widespread fatty infiltration of the right ventricular wall (right ventricular lipomatosis).
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Hiroshima et al. (2012) conducted a case report in Right ventricular lipomatosis and wall thinning (n=1). Soft J-tipped guide wire insertion via right subclavian vein was evaluated on Cardiac perforation and tamponade. Insertion of a soft J-tipped guide wire via the right subclavian vein caused fatal cardiac perforation and tamponade in a patient with right ventricular lipomatosis and severe wall thinning.
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