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Bruce R. Barton, MD; Gilbert Hermann, MD; Richard Weil III, MD

JAMA. 1983;250(19):2660-2662.

Abstract
Three adults have had life-threatening perforations of the vena cava or right atrium associated with the use of subclavian hemodialysis catheters. Subclavian hemodialysis catheters should be meticulously positioned in the superior vena-caval lumen so the tip does not tent the vena-caval wall. If a patient with a subclavian hemodialysis catheter experiences unexplained and refractory hypotension, especially during hemodialysis, cardiac or vena-caval perforation should be suspected.

(JAMA 1983;250:2660-2662)

Author Affiliations
From the Department of Surgery, University of Colorado School of Medicine (Drs Barton and Weil), and the Surgical Services of Rose Medical Center (Dr Hermann) and University Hospital (Drs Barton and Weil), Denver.

Footnotes
Reprint requests to Department of Surgery, University of Colorado Health Sciences Center, PO Box C-304, 4200 E Ninth Ave, Denver, CO 80262 (Dr Weil).

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