Finger Necrosis Resulting from Percutaneous Radial Artery Cannulation / 대한마취과학회지

ABSTRACT

The technique of radial artery cannulation and its complications are well documented. However, serious complications are rare. This is a report of one case of finger necrosis developed from the arterial cannulation in a patient who had open heart surgery. This 33 year old female underwent mitral valve replacement surgery with Carpentier Edward porcine prosthesis during a cardiopulmonary bypass. Right radial artery cannulation was carried out percutaneously using an 18 gauge angiocath after the Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. Cardiac arrest occured and the patient was resusciated 3 hours postoperatively. After that her blood pressure was maintained around 60/40 by dopamin drips. On the second postoperative day, her right hand became cold and dusky purple so that the catheter was removed, and a right stellate ganglion blcok was carried our. However, necrotic change on right thumb, index finger and little finger became worse and the whole palm became blue and edematous. She died of cardiac arrest on the 4th postoperative day.