Complication of right subclavian vein catheterization: Superior vena cava perforation

Abstract

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. A 65-year-old male patient was 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 (Stage IB, T2N0M0). 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 the 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 The catheter was withdrawn and vena cava superior was repaired with 5/0 prolene sutures. The patient didn't develop any post operative problems, thus he was discharged with full recovery following right lower bilobectomy.