Abstract
59-year-old woman was scheduled for mitral valvuloplasty and Maze operation. As operation was planed to use the robotically controlled camera (Aesop 3000, , USA) for the minimally invasive robot-assisted thoracotomy, a superior vena cava (SVC) cannula (Femoral arterial cannula [21 Fr], , USA) was inserted in the right internal jugular vein. After insertion of the SVC cannula, a pulmonary artery (PA) catheter (Swan-Ganz CCOmbo V [7.5 Fr], , USA) was inserted through an advanced venous access device (AVA 3Xi [8.5 Fr], , USA) in the right subclavian vein. The tip of the PA catheter could not be advanced into SVC and blood was not regurgitated. In the chest AP X-ray, it was found that the advanced venous access device was kinked by the SVC cannula. So the advanced venous access device was withdrawn about 5 cm and the PA catheter was advanced easily to the destination.
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