Accidental perforation of the left ventricle with a chest draintube.

Abstract

A 67-year-old man in severe respiratory distress was admitted to the intensive care unit. He had a history of non-insulin-requiring diabetes, arterial hypertension, dyslipidemia, hyperuricemia, bronchial asthma, and a double coronary artery bypass performed in our hospital in 1990. He was intubated and connected to mechanical ventilation. On a chest radiograph, a left pneumothorax was evident. A chest drain catheter (Pleurocath, Plastimed Laboratoire; Saint Leu la Foret, France) was inserted percutaneously in the left chest. After insertion, we observed a pulsatile hemorrhage through the distal end of the drain. Accidental perforation of the left ventricle was suspected and was documented by chest radiography (Fig. 1) and transthoracic echocardiography (Fig. 2). We performed emergency surgery through a limited left thoracotomy and removed the drain from the left ventricle. The left ventricular perforation was repaired with a 3-0 polypropylene suture. The patient tolerated the procedure well. His immediate postoperative condition was stable, and he was extubated in the intensive care unit. However, 13 days after surgery, the patient died suddenly. On postmortem examination, the most relevant finding was bilateral pneumonia. Fig. 1 Fig. 2