A complication of percutaneous cannulation of the internal jugular vein

Reviews of the use of the technique of percutaneous cannulation of the internal jugular vein for central venous pressure monitoring have indicated that it is free from serious complications. A patient is reported here in whom the ascending cervical artery was damaged during attempted cannulation of the internal jugular vein prior to aortic valve replacement. Haemorrhage from this site after the operation led initially to an extrapleural haematoma and soon afterwards to a haemothorax, which proved fatal despite immediate resuscitation and exploration. Percutaneous cannulation of the internal jugular vein is widely practised for central venous pres-sure monitoring during cardiac surgery. It was first described by English, Frew, Piggott, and Zaki (1969), who reported 200 cases without complication. Jernigan, Gardner, Mahr, and Milburn (1970) used it in 1,000 cases with three complications, all successfully treated. This report concerns a fatality arising from this technique