A 63-year-old Chinese woman, who had been receiving maintenance hemodialysis for 2 years, presented to the nephrologist with an exit site infection of hemodialysis catheter. The patient was assigned to a 3-days conservative treatment. However, the exit site infection had worsened to dacron cuff infection. Then, a left internal jugular vein tunneled hemodialysis catheter was planned to be inserted to replace the infected catheter. During the procedure, the patient suddenly developed profound hypotension and loss of consciousness. Computed tomography (CT) revealed hemopericardium with acute cardiac tamponade. Emergency pericardial drainage using the left dialysis catheter was performed immediately. Then a balloon catheter was placed in the left
