Soft J-tipped Guide Wire-induced Cardiac Perforation in a Patient with Right Ventricular Lipomatosis and Wall Thinning

Yuki Hiroshima; Katsushi Tajima; Yousuke Shiono; Ikuko Suzuki; Kei Kohno; Yuichi Kato; Kawamura Shunji; Takeo Kato

doi:10.2169/internalmedicine.51.7794

CASE REPORTS

Soft J-tipped Guide Wire-induced Cardiac Perforation in a Patient with Right Ventricular Lipomatosis and Wall Thinning

Yuki Hiroshima, Katsushi Tajima, Yousuke Shiono, Ikuko Suzuki, Kei Kohno, Yuichi Kato, Kawamura Shunji, Takeo Kato

Author information

Yuki Hiroshima
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan
Katsushi Tajima
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan
National Institute of Radiological Sciences, Japan
Yousuke Shiono
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan
Ikuko Suzuki
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan
Kei Kohno
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan
Yuichi Kato
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan
Kawamura Shunji
Department of Pathology, Tokyo Women's Medical University, Japan
Takeo Kato
Departments of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Yamagata University School of Medicine, Japan

Keywords: cardiac tamponade, cardiac perforation, central venous catheter, right ventricle, fatty infiltration, soft J-tipped guide wire

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 18 Pages 2609-2612

DOI https://doi.org/10.2169/internalmedicine.51.7794

Details

Abstract

Cardiac tamponade caused by perforation is a rare but potentially lethal complication of central venous catheter (CVC) insertion. We herein report a case of cardiac perforation associated with the use of a soft J-tipped guide wire. Twenty minutes after the insertion of a CVC, the patient developed unexpected cardiac arrest. An autopsy revealed 400 mL of pericardial blood. The right ventricular wall was 1 mm thick with about 10 myocyte layers, which is one-third that of the normal heart. A histological analysis revealed widespread fatty infiltration of the right ventricular wall (right ventricular lipomatosis).

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