Femoral Catheter Incision Blown Out with a Sneeze

If you're blood squeamish, move on and do not read the rest of this post.

I had an unsuccessful Micra implantation procedure Weds 11/2. The Micra was to be placed in my heart using a catheter inserted into the femoral artery in the groin. The morning after my procedure I was standing in my kitchen eating a banana. I sneezed once and felt some blood trickle from my hospital-dressed incision site. I sneezed a second time and my wound blew open pouring blood from my femoral vein. Envision pouring water from a 20oz water bottle. I immediately gave hard pressure and my wife called 911. Thank goodness she was there to assist. I laid in our doorway with her putting intense pressure on my femoral vein wound until the ambulance arrived and rushed me to an ER. Thankfully do to the pressure we applied in waiting and in the ambulance, the bleeding had basically stopped by the time we arrived at the hospital. After two hours they discharged me. While I was getting dressed in the room, it blew open again! Another couple hours in the ER. Thankfully for my wife (and secretly me) there was a Below Deck marathon on Bravo yesterday.

Home since Thursday evening and moving very slow, by choice. No more sneezes and coughs! To say the least that was one of the most traumatic events of my life. 

NO WHERE in my discharge paperwork did it warn against sneezing. The nurse actually said lifting could resume in just a few days which I knew was wrong since the PA I met with prior said nothing 10 lbs or more for at least 1 week.

Point of the story, treat femoral incisions like your life depends on it, because it does.


8 Comments

A lot to go through

by Persephone - 2022-11-04 17:34:21

I hope you're doing OK, MATTINMSP. Quite an ordeal. Two things:

If you're in an area with a lot of trees, it's possible that you may have an allergic reaction to trees rather than sensitivity to bananas - they have some connection. Sinus drainage issues could also be a contributing factor especially in the morning.

One of the really gross things my father told me when I was a young adult is that a sneeze is like an orgasm. Can't unremember that... point being that it's a forceful experience.

I hope your recovery goes well.

 

 

Not quite that dramatic

by crustyg - 2022-11-04 19:55:24

Sorry to contradict you, but a PM would have needed a femoral VEIN catheter - it's heading for the R Atrium or R Ventricle.  A line into your femoral artery would take you up to the aorta and potentially into the coronary arteries - ideal for putting in stents for IHD.

I've also suffered groin bleeding after a femoral vein puncture.  Eventually I had to have a purse-string suture around the puncture wound to stop it - fully anti-coagulated in my case for an ablation.  The pressure in the femoral vein when standing is quite high and even higher when coughing or sneezing.  You wouldn't want to stare too long at a pressure trace for the fluid around your brain - the pressures there are high for a few moments.

I think it's unwise to lose confidence in your EP-doc because of the groin bleed, but I accept and understand that the failed Micra implantation is also a factor.  One of the reasons why the docs go through the list of possible complications for your consent is that, sometimes, things do go wrong.  Not ideal but our bodies are different, we sometimes have different anatomy and our skin is less elastic than some others.  But in the end, it's your choice.

Correction

by MattinMSP - 2022-11-04 22:57:10

Crustyg, you're correct. It was femoral vein not the artery. I was wrong. But I assure you, this was dramatic. I've had ablations with subsequent bleeds too and the difference in incision size is a needle for the ablation vs a sharpie marker+ for the Micra. Blood soaked clothes and blood on the floor in just a few seconds. Nonetheless, I appreciate your correction and will update my post. 

Me too— femoral incision blown out

by brady - 2022-11-04 23:07:13

I just had a leadless dual chambers pm inserted through the fumoral vein. It had suture on it after surgery. The next day, before discharge the suture was removed. The floor doctor insisted that I walked before discharging me. I walked and the incision site busted open and blood dripped(not pouring)  down.
 

What I don't understand is that why not just leave the suture on for another day and ask the patient to cut it himself at home or use collagen plug as suggested by AgentX86 in another post.

Which Leadless?

by MattinMSP - 2022-11-04 23:24:14

@brady which leadless PM did you have implanted? 

I had a suture removed too with a walk to the bathroom. But they only kept me in the hospital for 4 hours after procedure. 

Hole in vein would be larger for a leadless PM than two sheaths for ablation

by crustyg - 2022-11-05 11:59:35

For an ablation there would normally be two sheaths / introducers to get the wires into the R side of the heart.  Still reasonably small.  To get a leadless PM into the vein would need a much larger hole - and this would take more time to achieve strength against the increased pressure of coughing or laughing.

Leadless Abbott dual chamber pacemaker i2i

by brady - 2022-11-05 20:48:49

MattinMSP, 

I have Leadless Abbott dual chamber pacemaker i2i.

I believe for the ventricle pacemaker, it is the same as what Abbott has been Offering commercially. if interested See

Abbott leadless  LP field trial results:

https://www.jacc.org/cms/asset/34c2cf0c-f4de-4ce0-85c1-95f6a46fb9ae/gr1.jpg?download

And Abbott brochure :

https://www.cardiovascular.abbott/us/en/hcp/products/cardiac-rhythm-management/pacemakers/aveir-vr-leadless-pacemaker.html?utm_source=paid+display&utm_medium=banner_gif&utm_campaign=pacemaker+club_aveir

Leadless PMs for the ventricle have been around for more  than 10 yrs. Abbott is the first company that came  up a leadless pm for the atrium. The problem for the dual chamber had been "communication" between the atrium and ventricle PMs. I believe Abbott atrium pm uses the heart muscle to communicate with the ventricle pm. The experiment was first done on pigs. After that it moved to human.

For people who are interested in having a ventricle pm, I would suggest consider Abbott. The advantage is that the ventricle pm could be upgraded to a pair of dual chamber PMs in the future by adding an atrium pm. 
 

after implant, I stayed in the hospital overnight and was discharged at noon.

Incision Blown Out with a Sneeze

by AgentX86 - 2022-11-05 21:04:57

Yeah, I can believe that but it's pretty hard to stifle a sneeze. The day after I got home from the hospital after my CABG I came down with bronchitis.  After a CABG one totes around a pillow to hold the sternum together in case of a cough.  Well bronchitis put a whole new meaning to pain.  A sneeze would take me right to the floor.  That was a bad month (two ER trips, too).

In addion to the motion of the sneeze, blood pressure spikes.  Blowing out a brand new patch in a femoral vein isn't very surprising. It's a good thing it wasn't the artery! 

You know you're wired when...

You have a high-tech ticker.

Member Quotes

I am just now 40 but have had these blackouts all my life. I am thrilled with the pacer and would do it all over again.