PMC6279962_01
Intraoperative fluoroscopy: Unusual course of the guidewire on the left side then traversing across the midline with the tip projects over the right atrium (arrows).
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fig1
Trendelenburg and on the first pass, dark blood was aspirated and on removal of the syringe it was not pulsating. The guidewire was advanced without any problems and thereafter a chest x-ray was taken (Fig. 1).
Angiography: 2a: The tube is positioned within the pulmonary artery (arrow). 2b: The catheter is slowly pulled back and out of the pulmonary artery (arrow).
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fig2
However, upon injection of contrast the pulmonary artery filled (Fig. 2).
CT Angiography: 3a: sagittal view: The tip of the catheter is outside of the PA, no active extravasation of contrast is seen (arrow), 3b: transverse view: 3cm mediastinal hematoma (arrow).
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fig3
There was no active bleeding observed; however, a 3cm hematoma in the left upper mediastinum was seen (Fig. 3).