Innominate artery repair via upper sternotomy after misplacement of central venous catheter - a case report -

We experienced a case where a central venous catheter was incorrectly placed into the innominate artery while attempting to be placed into the right subclavian vein. An 87-year-old woman underwent central venous catheterization without ultrasound in the intensive care unit for treating septic shock caused by exacerbation of acute cholecystitis. Subsequent hemodynamic monitoring through this catheter revealed arterial waves, suggesting iatrogenic cannulation of the artery. And chest X-ray revealed that central line coursed more medial than expected with the tip appeared to be located within the aorta. Three-dimensional spectral computed tomography of the aortic arch showed that the entry point was the innominate artery of the aortic arch, and the tip was in the ascending aorta. Considering the patient’s condition and the coagulation test result, suturing after surgical removal through general anesthesia was decided. The catheter was successfully removed by surgery with upper sternotomy.