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Catheter inside the right heart for 22 years: to intervene or not to intervene?

Çimen T, Doğan M, Akyel A, Yeter E - Postepy Kardiol Interwencyjnej (2015)

Bottom Line: Catheters that have stayed inside the heart for a long time are removed due to the risk of distal embolisation and endocarditis, but the risk of removal is not known.Non-invasive follow-up of asymptomatic patients is often preferred because of the stabilisation of the embolised catheter due to endothelisation and the risk of complications during removal.Treatment of patients with catheter-piece emboli who are asymptomatic should be individualised, taking into account the risk of thrombosis, arrhythmia, and infection.

View Article: PubMed Central - PubMed

Affiliation: Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey.

ABSTRACT
Treatment of a central venous catheter emboli that has been asymptomatic for a number of years is controversial. A 56-year-old male patient who had an operation for sinus Valsalva aneurism rupture 22 years ago was referred to cardiology department for routine control. He had a mass inside the right heart on echocardiographic examination, and computed tomography revealed that this mass was an embolic piece of catheter. Catheters that have stayed inside the heart for a long time are removed due to the risk of distal embolisation and endocarditis, but the risk of removal is not known. Non-invasive follow-up of asymptomatic patients is often preferred because of the stabilisation of the embolised catheter due to endothelisation and the risk of complications during removal. Treatment of patients with catheter-piece emboli who are asymptomatic should be individualised, taking into account the risk of thrombosis, arrhythmia, and infection.

No MeSH data available.


Related in: MedlinePlus

Placement of the catheter on the right heart on three-dimensional computed tomography angiography
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Figure 0003: Placement of the catheter on the right heart on three-dimensional computed tomography angiography

Mentions: A 56-year-old male patient who had an operation for sinus valsalva aneurism rupture 22 years previously was referred to the cardiology department for routine control. He had no complaint. He was unable to find his surgical report. In his medical history he had hypertension and aortic operation. On physical examination he had soft early diastolic murmur at left sternal border. The ECG was at sinus rhythm. On transthorasic examination he had ascending aortic dilatation (5 cm) and minimal aortic regurgitation. In addition he had a hyperechogenic mass resembling a pacemaker electrode extending from the right atrium to the right ventricle. This piece was not radio-opaque on the chest X-ray (Figure 1). Cardiac computed tomography (CT) angiogram revealed that this piece was a catheter extending from the right ventricle to the right atrial appendage (Figures 2–3). The catheter fragment was approximately 14 cm long and had a diameter of 3.3 mm. He had no arrhythmia on 24-hour Holter monitoring. The patient was asymptomatic and decided to be followed noninvasively.


Catheter inside the right heart for 22 years: to intervene or not to intervene?

Çimen T, Doğan M, Akyel A, Yeter E - Postepy Kardiol Interwencyjnej (2015)

Placement of the catheter on the right heart on three-dimensional computed tomography angiography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372636&req=5

Figure 0003: Placement of the catheter on the right heart on three-dimensional computed tomography angiography
Mentions: A 56-year-old male patient who had an operation for sinus valsalva aneurism rupture 22 years previously was referred to the cardiology department for routine control. He had no complaint. He was unable to find his surgical report. In his medical history he had hypertension and aortic operation. On physical examination he had soft early diastolic murmur at left sternal border. The ECG was at sinus rhythm. On transthorasic examination he had ascending aortic dilatation (5 cm) and minimal aortic regurgitation. In addition he had a hyperechogenic mass resembling a pacemaker electrode extending from the right atrium to the right ventricle. This piece was not radio-opaque on the chest X-ray (Figure 1). Cardiac computed tomography (CT) angiogram revealed that this piece was a catheter extending from the right ventricle to the right atrial appendage (Figures 2–3). The catheter fragment was approximately 14 cm long and had a diameter of 3.3 mm. He had no arrhythmia on 24-hour Holter monitoring. The patient was asymptomatic and decided to be followed noninvasively.

Bottom Line: Catheters that have stayed inside the heart for a long time are removed due to the risk of distal embolisation and endocarditis, but the risk of removal is not known.Non-invasive follow-up of asymptomatic patients is often preferred because of the stabilisation of the embolised catheter due to endothelisation and the risk of complications during removal.Treatment of patients with catheter-piece emboli who are asymptomatic should be individualised, taking into account the risk of thrombosis, arrhythmia, and infection.

View Article: PubMed Central - PubMed

Affiliation: Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey.

ABSTRACT
Treatment of a central venous catheter emboli that has been asymptomatic for a number of years is controversial. A 56-year-old male patient who had an operation for sinus Valsalva aneurism rupture 22 years ago was referred to cardiology department for routine control. He had a mass inside the right heart on echocardiographic examination, and computed tomography revealed that this mass was an embolic piece of catheter. Catheters that have stayed inside the heart for a long time are removed due to the risk of distal embolisation and endocarditis, but the risk of removal is not known. Non-invasive follow-up of asymptomatic patients is often preferred because of the stabilisation of the embolised catheter due to endothelisation and the risk of complications during removal. Treatment of patients with catheter-piece emboli who are asymptomatic should be individualised, taking into account the risk of thrombosis, arrhythmia, and infection.

No MeSH data available.


Related in: MedlinePlus