1/9. Indwelling catheter-induced right ventricular rupture.We describe a case of a 68-year-old man who, because of postoperative mediastinitis, underwent a multiple muscle flap closure of the mediastinum. A chronic indwelling catheter led to erosion and rupture of the anterior wall of the right ventricle. The near exsanguinating hemorrhage was corrected under circulatory arrest. A pericardial patch repair was performed with good results.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
2/9. Infected mediastinitis secondary to perforation of superior vena cava by a central venous catheter.We describe the first case of infected mediastinitis associated with central venous catheter insertion. The rare occurrence of this complication may be explained by the fact that it results from central venous catheter-related bloodstream infection and catheter perforation of superior vena cava. The symptoms of this complication (chest pain, dyspnoea) are not specific. Diagnosis should be confirmed by chest x-ray and computerized tomography which show hydromediastinum and pleural effusion. Removal and subsequent culture of the catheter tip will confirm infection. Appropriate antibiotic therapy, guided by sensitivities of the cultured organisms, should be commenced. Any pleural effusion should be drained by thoracocentesis, and the pleural fluid cultured. In case of fever, bacteraemia or shock, a thoracotomy to drain mediastinal and pleural effusions may be considered.- - - - - - - - - - ranking = 1.6keywords = catheter (Clic here for more details about this article) |
3/9. Unilateral pulmonary edema due to pulmonary venous obstruction from fibrosing mediastinitis.An unusual case of fibrosing mediastinitis with obstruction of the inferior and superior left pulmonary veins and severe narrowing of the right pulmonary artery, disclosed after unilateral pulmonary edema, is described. The 18-year-old male patient had a long history of cough, progressive dyspnea and recurrent hemoptysis and the possible diagnosis of "interstitial fibrosis" from a previous lung biopsy. The diagnosis and the pulmonary vessels involvement were suspected after right heart catheterization combined with transesophageal echocardiography and confirmed during urgent thoracotomy and at postmortem examination.- - - - - - - - - - ranking = 0.2keywords = catheter (Clic here for more details about this article) |
4/9. skin grafting for repair of a cardiac laceration.rupture of the right ventricle has been reported as a complication of closed catheter irrigation in poststernotomy mediastinitis. We report the case of a right ventricular rupture that was repaired with a deepithelialized dermal skin graft. The technique is described and management options for these difficult wounds are discussed.- - - - - - - - - - ranking = 0.2keywords = catheter (Clic here for more details about this article) |
5/9. Acute purulent mediastinitis and sternal osteomyelitis after closed chest cardiopulmonary resuscitation: a case report and review of the literature.Numerous complications have been associated with cardiopulmonary resuscitation. Acute purulent staphylococcal mediastinitis and sternal osteomyelitis are, however, unusual and do not appear to have been reported previously in association with closed chest resuscitation. Sternal fracture during chest compressions and subsequent hematogenous seeding of the resultant retrosternal hematoma with staphylococcus aureus led to purulent mediastinitis and sternal osteomyelitis in our patient. The source of bacteremia may have been a resolving phlebitis at an intravenous catheter insertion site. early diagnosis, aggressive surgical debridement, and antibiotic therapy were key to a successful outcome.- - - - - - - - - - ranking = 0.2keywords = catheter (Clic here for more details about this article) |
6/9. Recurrent cardiac constriction after pericardiectomy.Dependent edema, ascites, and exertional dyspnea developed in a patient seven months after pericardiectomy for constrictive pericarditis. cardiac catheterization documented constrictive physiology. At the second operation, he was found to have extensive mediastinal fibrosis that encased the heart. Postmortem examination showed a fibrocartilagenous exoskeleton that encased both ventricles. Possible etiologies for this unusual reconstriction are discussed.- - - - - - - - - - ranking = 0.2keywords = catheter (Clic here for more details about this article) |
7/9. chylothorax: a complication of subclavian vein catheterization and parenteral hyperalimentation.A case is presented in which a unique combination of events occurred as a complication of subclavian vein catheterization. Extravasation of intravenous hyperalimentation solution occurred, resulting in mediastinitis and venous obstruction of the jugulosubclavian confluence bilaterally. Bilateral chylothorax resulted which was successfully managed by conservative means. The methods used and the rationale for their employment are discussed.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
8/9. Acute mediastinitis secondary to leakage of parenteral nutrition from a migrated central venous catheter in a patient undergoing autologous bone marrow transplant.We describe an unusual case of pyrexia of unknown origin in a patient undergoing autologous bone marrow transplantation for metastatic breast cancer. The fever was due to extravasation of lipid-containing hyperalimentation fluid from a migrated central venous catheter into the mediastinum, resulting in mediastinitis and pleurisy. The fever persisted despite broad-spectrum antibiotics and amphotericin b, and finally responded to steroids.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
9/9. mediastinitis related to probable central vinblastine extravasation in a woman undergoing adjuvant chemotherapy for early breast cancer.Adjuvant chemotherapy for breast cancer, although generally safe and of proven benefit, can have severe complications. Central venous catheter (CVC) complications are relatively common forms of treatment-related morbidity in this setting. We report a rare type of CVC-related complication, that of chemotherapy-induced mediastinitis from central venous extravasation of the drug vinblastine, in a women undergoing adjuvant chemotherapy. The patient presented with signs and symptoms consistent with mediastinitis, but the diagnosis was delayed because the initial findings were nonspecific and there was little suspicion for a CVC-related problem. A radionuclide venous flow study was misleading, but a computed tomographic study of the chest and contrast venography confirmed the diagnosis. Conservative treatment with CVC removal, systemic anticoagulation, antibiotics, and pain controlled to gradual improvement in the patient's clinical status. More aggressive strategies, such as thrombolytic therapy and surgical intervention, were considered, but these approaches have not been used in this particular setting. The complication reported here is the first described in the literature in an adult patient. Two similar cases have been reported in pediatric patients. It is likely that this clinical problem is underreported. patients with CVCs actively undergoing chemotherapy with vesicant agents should be watched carefully for early signs of CVC disruption and subsequent extravasation, as it is likely that early intervention will be of benefit.- - - - - - - - - - ranking = 0.2keywords = catheter (Clic here for more details about this article) |