case_images: PMC9902637_01
case_images: Preoperative chest radiograph with Perm catheter tip in place (black arrow).
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case_images: Preoperative chest radiograph showed an appropriately positioned HemoSplit (BD, USA) catheter, a split-tip form of the Perm catheter, inserted through the right subclavian vein (Fig. 1).
case_images: Intraoperative chest radiograph after Swan-Ganz catheter insertion. The mid to distal portion of Perm catheter was positioned in the left brachiocephalic vein, with a flexure in the middle and the tip in superior vena cava (black arrow).
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case_images: The mid- to distal portion of the Perm catheter was positioned in the left brachiocephalic vein, with a flexure in the middle and the tip in the superior vena cava (Fig. 2).
case_images: Postoperative chest radiograph showing intraoperative manual repositioning of Perm catheter had resulted in looping of the catheter tip (black arrow).
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case_images: However, a postoperative chest radiograph revealed that manual repositioning of the Perm catheter was incomplete and the tip remained looped (Fig. 3).
case_images: Chest radiograph after successful radiologic procedure to reposition the Perm catheter, showing the tip back in the original place (black arrow).
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case_images: An Amplatz guidewire was successfully inserted through each lumen of the looped catheter to carefully straighten the catheter and reposition the tip in the right atrium (Fig. 4).