Abstract
Introduction: Injury to the heart during chest drainage is a very rare bud potentially fatal complication of the procedure. Case report: A 56-year-old, polymorbid, poorly co-operative and extremely obese patient with chronic cardiac subcompensation and pleural effusion was admitted to a district hospital.
A drain was inserted into the left pleural cavity in order to evacuate the pleural effusion. Fresh oxygenated blood was flowing out from the drain.
The drain was clamped immediately. Echocardiography showed drain insertion into the left ventrikle.
A cardiac surgeon was contacted and indicated patient transfer to a cardiac surgery department followed by an emergency surgery. During the surgery performed through a left thoracotomy, a defect in the left ventricular wall was sutured.
The patient was then stabilized, transferred back to the district hospital and, after achieving cardiopulmonary compensation, discharged home. Conclusion: Injury to the heart in chest drainage is a very serious iatrogenic complication.
If it is to be managed succesfully, the site of the insertion of the drain tip needs to be correctly identified and the drain must not be extracted. A surgical department capable of adequately addresing this complication needs to be contacted promptly, as emergeny surgery may be the only lifesaving possibility.