Cardiovasc Imaging Asia.  2022 Oct;6(4):114-116. 10.22468/cvia.2022.00129.

Dislodgement of a Large, Catheter-Related Right Atrial Thrombus

• Theerasuwipakorn N
• Sitticharoenchai P
• Singhatanadgige S
• Chattranukulchai P

• KMID: 2534910
• DOI: http://doi.org/10.22468/cvia.2022.00129

Abstract

Isolated right atrial (RA) thrombus at the catheter tip is an uncommon complication of central venous catheter placement. We present the case of a 41-year-old woman with end-stage renal disease who underwent regular hemodialysis via a permanent right subclavian catheter. A large RA mass was found on echocardiographic workup for recurrent intradialytic hypotension. Subsequent cardiac computed tomography demonstrated an RA thrombus at the catheter tip. After treatment with an anticoagulant, the thrombus dislodged toward the tricuspid valve inflow, causing significant obstruction. Emergency surgical mass removal was successful and the postoperative period was uneventful. This case highlights the importance of proper positioning of indwelling central venous catheters to prevent this unusual complication, which required emergency surgery.

Keyword

Thrombosis; Catheters; Transthoracic echocardiography; Embolectomy; Embolism