Femoral Catheter Incision Blown Out with a Sneeze

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. 

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.

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!