ABSTRACT
A 52-year-old man presented himself to his family doctor for uremia associated with prerenal acute renal failure. A 12 Fr vascular access catheter was inserted via the right internal jugular vein for emergency dialysis. A contrast-enhanced computed tomography (CT) scan revealed that the catheter had penetrated the right internal jugular vein, perforated the right subclavian artery, and reached the ascending aorta. Under general anesthesia, we completed the procedure with a pull-through technique between the bilateral brachial arteries. A vascular occlusion balloon was inserted from the left brachial artery and a GORE VIABAHN stent graft was inserted from the right brachial artery. The postoperative course was good and he has been free from hemorrhagic episodes. He was transferred to the referring hospital on postoperative day 2.
ABSTRACT
A-75-year-old man had refractory late cardiac tamponade after an off-pump coronary artery bypass grafting. He was initially treated by pericardiocentesis with oral nonsteroidal anti-inflammatory drugs, but the treatment failed. Pericardial fenestration was conducted twice for refractory pericardial effusion during his hospitalization. He presented again with recurrence of cardiac tamponade 2 months after the last pericardial fenestration. Therefore, a pleuroperitoneal shunt system was implanted. He recovered well and was discharged without reaccumulation of pericardial effusion.