Abstract
A 68-year-old male with end-stage renal disease, congestive heart failure, and facial
and bilateral arm swelling was referred for placement of a tunneled dialysis catheter.
Distal left subclavian vein access was obtained. The procedure was complicated by
iatrogenic perforation of the superior vena cava (SVC). This resulted in rapid development
of a right-sided hemothorax and hemodynamic instability. A right-sided thoracostomy
tube was placed to drain the pleural cavity.
Extrapericardial perforation of the SVC can be managed conservatively in select cases
without endovascular balloon dilatation and/stent graft deployment or surgical repair
provided the antegrade blood flow is maintained via patent collateral circulation.
Keywords
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Article info
Publication history
Published online: August 05, 2013
Accepted:
April 25,
2013
Received in revised form:
February 23,
2013
Received:
November 2,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
