GKD Anest Yoð Bak Dern Derg. 2013; 19(2): 103-105 | DOI: 10.5222/GKDAD.2013.103

Sað Subklaviyan Venöz Kateterizasyonun Nadir Bir Komplikasyonu: Superior Vena Kava Perforasyonu

Burçin Çelik¹, Serhat Kocamanoðlu², Yasemin Bilgin Büyükkarabacak¹, Esra Sarýhasan^2
1Ondokuz Mayýs Üniversitesi Týp Fakültesi Göðüs Cerrahisi Anabilim Dalý, Samsun
²Ondokuz Mayýs Üniversitesi Týp Fakültesi Anesteziyoloji Ve Reanimasyon Anabilim Dalý, Samsun

Santral venöz kateterizasyon toraks operasyonlarýnda rutin kullanýlan invaziv bir giriþimdir. En sýk komplikasyonlar pnömotoraks ve hemotorakstýr. Komplikasyon olarak vena kava superior (VKS) perforasyonuna (%0.5) oldukça nadir rastlanmaktadýr.
Altmýþ beþ yaþýnda erkek hasta öksürük þikayeti ile hastanemize baþvurdu. Hastada sað akciðer alt lobda lokalize akciðer epidermoid kanser tespit edildi. Ameliyat öncesi hazýrlýk olarak anestezi ekibi tarafýndan hastaya endotrakeal entübasyon ve sað subklaviyan ven kateterizasyonu uygulandý. Eksplorasyonda, yerleþtirilen santral kateterin sað subklaviyan veni perfore ettiði ve kýsa bir mesafe intratorasik boþlukta seyrettikten sonra frenik sinirin önünden vena kava superiora girdiði izlendi. Kateter geri çekilerek vena kava superior 5/0 prolen ile onarýldý. Hastada postoperaitf dönemde herhangi bir problem geliþmedi ve sað alt bilobektomi sonrasý sorunsuz olarak taburcu edildi.

Anahtar Kelimeler: subklaviyan ven kateterizasyonu, komplikasyon, superior vena kava perforasyonu, santral venöz kateterizasyon

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Complication of Right Subclavian Vein Catheterization: Superior Vena Cava Perforation

Burçin Çelik¹, Serhat Kocamanoðlu², Yasemin Bilgin Büyükkarabacak¹, Esra Sarýhasan^2
1Ondokuz Mayýs University Medical School Department Of Thoracic Surgery, Samsun, Turkey
²Ondokuz Mayýs University Medical School Department Of Anesthesiology And Reanimation, Samsun, Turkey

Central venous catheterization is an invasive approach which is routinely used in thoracic surgery operations. Pneumothorax and hemothorax are among the most frequent complications. Vena cava superior (VCS) perforation (0.5%) is very rarely observed.
The 65-year-old male patient admitted to the hospital with the complaint of cough. With the examinations performed, he was diagnosed with epidermoid lung cancer located in the right lower lobe of the lung. To prepare the patient for the operation, endotracheal intubation and right subclavian vein catheterization were performed by the anesthesia team. During exploration, it was found that central catheter placed into the right subclavian vein perforated the vein and after proceeding a little in the intrathoracic space, entered the vena cava superior in front of the phrenic nerve. The catheter was withdrawn and vena cava superior was repaired with 5/0 prolene suture. The patient developed no post operative problems, thus he was discharged with full recovery following right lower bilobectomy.

Keywords: subclavian vein catheterization, complication, superior vena cava perforation, central venous catheterization

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