Adverse hemodynamic response due to malposition of central venous catheter

Abstract

Central venous catheter (CVC) is an inescapable requirement of any cardiac surgery for administering drugs including inotropes, cardiac pacing, and invasive monitoring during the perioperative period. Central venous access involves triple-lumen catheter inserted in the internal jugular or femoral vein. The preferred vein for CVCs is the right internal jugular vein because of straighter course to the right heart, better visibility on ultrasonography, lowest risk of the venous stenosis and thrombosis, and also keeping in mind the nature of surgery involved and patient positioning. Malposition of the catheter is a relatively common complication (5.01%) which results in the malfunction of catheters. We report a case of a malposition of a CVC in a 70-year-old male who underwent mitral and aortic valve replacement along with coronary artery grafting for the posterior descending artery on cardiopulmonary bypass.

Keywords

• central venous catheter
• fluoroscopy
• hemodynamic variations
• internal jugular vein
• malposition
• ultrasonography guidance