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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2012 February;25(1):35-7
Right-atrial thrombus formation as a complication of tunnelled cuffed hemodialysis catheter and surgical treatment
Çeliksöz M., Keskin H. A., Bayraktaroglu M. S., Atasoy Ş., Katircioglu F. S.
Department of Cardiovascular Surgery, Etlik İhtisas Training Hospital, Ankara, Turkey
Although the preferred vascular access route for chronic hemodialysis patients is an AV fistula or an AV graft, some patients have to use temporary or permanent tunneled cuffed hemodialysis catheters when the fistula or graft is not available for some reason. Formation of right atrial thrombus is a serious complication of these catheters. We present a case of a 36-year-old, female, chronic renal insufficiency patient who presented with the findings of catheter infection. In her investigation a thrombus formed around the tip of a tunneled cuffed hemodialysis catheter was diagnosed by transthoracic echocardiography. She was treated successfully by surgical removal of the thrombus. Right atrial catheters are not free of adverse effects. Although transesophageal echocardiography (TEE) is a sensitive method for their diagnoses, transthoracic echocardiography is less invasive and easier to perform and good means to screen and to investigate the complications of these prolonged times indwelling catheters of right atrium especially of tunneled cuffed haemodialysis catheters. Magnetic resonance imaging is also useful to determine if the thrombus organized or not. Medical treatment is an option for small (≤20 mm) non organized thrombus where as for big (≥20 mm) and organized thrombus surgical removal is often suggested.