Another Complication of Thoracostomy—Perforation of the Right Atrium

Iatrogenic Perforation of the Left Ventricle Following Chest Drain Insertion

“…The insertion should be done within the safety triangle, which is marked by the anterior border of the latissimus dorsi muscle, the lateral border of the pectoralis major, a horizontal line above nipple level, and an apex below the axilla [1]. Most cardiac injuries during the procedure were related to anatomic distortion such as post-pneumonectomy, extreme kyphoscoliosis, and cardiomegaly [5][6][7][8]. Our patient had marked cardiomegaly which made the left heart border close to the chest wall another factor was the avoidance of the use of image guidance.…”

The Analysis of the Chest Tube Thoracostomies Performed in a Newly Established Hospital of a Medical School

“…Inadequate air or fluid drainage, drain malposition, intraabdominal drain placement, parenchymal lung injury, diffuse subcutaneous emphysema can be observed in patients who have undergone CTT. In addition to these, complications such as pulmonary infarction secondary to internal mammarian artery erosion, esophagus perforation, gastric perforation, pulmonary artery or intercostal artery injuries, cardiogenic shock due to right ventricular compression have been defined in several studies [4][5][6][7][8][9][10]. The most serious complications are related to the drain placement techniques [1,11,12].…”

Lateral Thoracostomy Tubes: Is Outcome Affected by Level of Intercostal Space?

“…The current recommendation is to achieve a position in what was described as the "safe triangle" which encompasses the 3 rd through 5 th intercostal spaces [6]. Such placement is thought to decrease various complications associated with lateral tube placement including pulmonic perforation [7] cardiac perforation [8][9][10] neurovascular injury [11][12][13] intra-abdominal placement and diaphragmatic injury [14][15][16][17][18]. The latter two complications are of particular concern with lower tube placement due to the proximity of the diaphragm and abdominal cavity to the lower intercostal spaces.…”