We present a case of the successful repair of an iatrogenic central vein lesion using a videothoracoscopic approach. The confluence of the right innominate vein and the superior vena cava was perforated during the placement of a right internal jugular vein long-term dialysis catheter. The misplacement of the tips of the catheter in the right pleural space was promptly observed. The catheter was removed under pleural videothoracoscopic vision while a tamponade was directly applied to the mediastinal perforation. Massive bleeding was prevented and the central vein perforation was treated successfully using a minimally invasive technique.
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