Reply to in Response to Guidewire Entrapped in the Right Ventricle

Ankur Verma¹, Sanjay Jaiswal², Amit Vishen³, Wasil R Sheikh⁴, Meghna Haldar⁵, Rinkey Ahuja⁶, Varun Chitransh⁷

^1–7Department of Emergency Medicine, Max Super Specialty Hospital, IP Extension, Patparganj, Delhi, India

Corresponding Author: Ankur Verma, Department of Emergency Medicine, Max Super Specialty Hospital, IP Extension, Patparganj, Delhi, India, Phone: +91 9971779998, e-mail: anksv25@gmail.com

How to cite this article Verma A, Jaiswal S, Vishen A, Sheikh WR, Haldar M, Ahuja R, et al. Reply to in Response to Guidewire Entrapped in the Right Ventricle. Indian J Crit Care Med 2020;24(7):608.

Source of support: Nil

Conflict of interest: None

Keywords: Central venous catheters insertion lengths, Dialysis catheter, Guidewire complication.

Sir,

The HD catheter set used by our resident was an ARROW CS-121123-F that has a 60-cm guidewire. It did not have a safe length marking and the overzealous attempt did lead to the entrapment. The technique described by Unnikrishnan et al. helps in straightening the J-tip of the guidewire but does not mention the same technique for entrapped guidewires. The technique described by them would be beneficial for guidewires where the J-tip gets stuck against the proximal sharp edge of the bevel of the introducer needle. The guidewire in our patient was entrapped in the right ventricle. A blind maneuver to release the guidewire might have had disastrous complications. Hence, it was removed under live 2-D echocardiography guidance. We also recommend having cardiothoracic surgeons on standby. We agree that during insertion, remembering the safe length and avoiding overzealous insertion would avoid complications like entrapment or coiling.

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