Breast necrosis secondary to vasopressor extravasation: management using indocyanine green angiography and omental flap closure

Extravasation is a rare but serious complication of vasopressor administration. A 60-year-old female who underwent ascending and hemiarch repair of the aorta along with aortic valve replacement developed extensive right breast and chest wall necrosis after vasopressor extravasation from an internal...

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Bibliographic Details
Published in:	The breast journal Vol. 21; no. 2; p. 185
Main Authors:	Hagopian, Thomas M, Ghareeb, Paul A, Arslanian, Brian H, Moosavi, Benjamin L, Carlson, Grant W
Format:	Journal Article
Language:	English
Published:	United States 01-03-2015
Subjects:	Angiography - methods Breast - pathology Breast - surgery Coloring Agents Extravasation of Diagnostic and Therapeutic Materials - diagnosis Extravasation of Diagnostic and Therapeutic Materials - etiology Extravasation of Diagnostic and Therapeutic Materials - surgery Female Humans Indocyanine Green Mammaplasty - methods Mastectomy Middle Aged Necrosis - chemically induced Surgical Flaps Vasoconstrictor Agents - adverse effects Vasopressins - adverse effects extravasation indocyanine green angiography chest wall reconstruction omental flap
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Summary:	Extravasation is a rare but serious complication of vasopressor administration. A 60-year-old female who underwent ascending and hemiarch repair of the aorta along with aortic valve replacement developed extensive right breast and chest wall necrosis after vasopressor extravasation from an internal jugular vein central line. The patient underwent a total mastectomy due to deep tissue necrosis detected by laser-assisted indocyanine green dye angiography, and eventually required omental flap reconstruction to obtain adequate sternal coverage. This case represents a previously unreported complication of internal jugular central line extravasation of vasopressors with resultant breast and chest wall necrosis, and highlights the utility of the omentum in chest wall reconstruction.
ISSN:	1524-4741
DOI:	10.1111/tbj.12379