Iatrogenic intramural hematoma of the ascending aorta complicating inadvertent arterial cannulation during central venous catheter placement. A case report and review of the literature

Abstract

Aortic injury during central venous catheter (CVC) insertion is a rare but serious complication. This presentation describes a case of iatrogenic intramural hematoma of the ascending aorta complicating inadvertent arterial cannulation of the right subclavian artery during attempted Port-A-Cath insertion at the right subclavian vein. Various strategies for the prevention and management of aortic injury during CVC placement are discussed. In this case, the hematoma was managed surgically and replacement of the ascending aorta was undertaken under deep hypothermic circulatory arrest.

Keywords

• aorta
• central venous catheter
• fluoroscopy
• intramural hematoma
• ultrasound