The story of a lost guidewire

Bagaria, Dinesh; Kaman, Lileshwar

doi:10.7196/sajcc.195

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Overall, missing a guidewire can be prevented by following a simple checklist of steps, starting with avoiding any kind of distractions, checking that the guidewire is longer than the catheter, always holding the proximal end of the guidewire during dilation and insertion of the catheter, looking over the guidewire on the tray after finishing the procedure, and, finally, conducting a routine chest X-ray to scan for any missing guidewires or CVC complications to ensure that the line is in place to start your infusions [ 9 ]. All these measures together will reduce or even prevent iatrogenic complications.…”

Section: Discussionmentioning

confidence: 99%

A 47-Year-Old Woman with a Retained Central Venous Catheter Line Guidewire Presenting with a Right Atrial Thrombus Requiring Removal During Open Heart Surgery: A Case Report

Alsaka Amini,

Alzuabi,

Baniyaseen

et al. 2023

Am J Case Rep

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Patient: Female, 47-year-old Final Diagnosis: Right atrial mass due to missed central venous catheter guidewire Symptoms: Shortness of breath Clinical Procedure: Open heart surgery Specialty: Anesthesiology • Cardiac Surgery • Cardiology • Critical Care Medicine Objective: Rare coexistence of disease or pathology Background: A central venous catheter (CVC) is an indwelling catheter that is inserted into a large central vein for different purposes, including hemodynamic monitoring and administration of fluids and medications. This report is of a 47-year-old woman with a retained CVC line guidewire presenting with a large right atrial thrombus requiring removal during open heart surgery. CVC insertion is one of the most frequently attempted procedures in intensive care units, emergency departments, and operation rooms, especially for critically ill patients. Possible complications range from failure to place the catheter to cardiac arrest. One of the rarest complications is missing the guidewire after insertion, which is usually discovered early after inserting it. Case Report: We report the case of a 47-year-old woman who had a CVC line inserted following complicated open cholecystectomy. A few years later, she developed shortness of breath, with an incidental finding of a huge right atrial thrombus and a wire shown on transthoracic echocardiography. The right atrial thrombus required open heart surgery to excise the thrombus and the wire, which was done successfully. The thrombus was histopathologically and clinically proven to be an organized right atrial thrombus formed around the CVC guidewire. Conclusions: This case report presents a rare complication of CVC insertion. Because this procedure is increasingly used, clinicians should be aware of the potential complications of retained CVC lines. Moreover, this report outlines different techniques to prevent such fatal complications and emphasizes the significance of radiography after insertion.

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Section: Discussionmentioning

confidence: 99%