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  • Ministernotomy repair of inadvertent proximal right subclavian artery injury following right internal jugular central venous catheter insertion

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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Ministernotomy repair of inadvertent proximal right subclavian artery injury following right internal jugular central venous catheter insertion
  1. Myat Soe Thet1,
  2. Jimmy Kyaw Tun2,
  3. Aung Ye Oo1 and
  4. Ana Lopez-Marco1
  1. 1Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
  2. 2Department of Interventional Radiology, The Royal London Hospital, London, UK
  1. Correspondence to Myat Soe Thet; myatsoe.thet{at}nhs.net

Abstract

A man in his 60s was referred for urgent coronary artery bypass grafting (CABG) procedure following acute coronary syndrome. After induction of general anaesthesia, right jugular venous catheterisation under two-dimensional ultrasound guidance was planned as part of perioperative management. While obtaining vascular access, the pulsatile flow was noted once the dilator was inserted, having to abandon the procedure and immediately apply manual pressure. CT angiogram showed proximal right subclavian artery injury with active contrast extravasation and resultant large haematoma in the neck. The patient underwent urgent exploration of the injured vessel through a J-shaped ministernotomy, and primary repair of the artery was performed. The patient recovered from the procedure without any complications. He continued to stay in the hospital for a few days, afterwards, he underwent the initially planned CABG surgery. He was discharged home on day 5 after surgery without further concerns.

  • Anaesthesia
  • Cardiothoracic surgery
  • Vascular surgery

https://doi.org/10.1136/bcr-2021-247809

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    Footnotes

    • Contributors MST: data acquisition, writing—original draft, review and editing, final approval. JKT: data acquisition, writing—review and editing, final approval. AYO: supervision, writing—review and editing, fInal approval. AL-M: data acquisition, writing—review and editing, supervision, final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.