Retrieval of Port-A Catheter Fragment from the Main and Right Pulmonary Arteries 3 Years after Dislodgment

2008 ◽  
Vol 9 (4) ◽  
pp. 296-298 ◽  
Author(s):  
M.I. Elkhoury ◽  
W.D. Boeckx ◽  
E.G. Chahine ◽  
M.A. Feghali

Vascular access (VA) is one of the serious problems that chemotherapy recipient cancer patients face. Fractures of catheter and cardiac migration rarely occur; the catheter fragments migrate distally along the blood stream finally lodging anywhere in the vena cava, right atrium, right ventricle, or the main pulmonary artery or one of its branches. Percutaneous retrieval method is always suggested first.

PEDIATRICS ◽  
1963 ◽  
Vol 32 (4) ◽  
pp. 776-777
Author(s):  
Albert A. Kattus

THE FOLLOWING CASE is presented in order to introduce a note of caution into consideration of the advisability of recommending unmonitored exercise for patients with heart disease. The patient is a 24 year old third year medical student who had been known to have a heart murmur since birth. He had lived a vigorously active life and had participated in high school football as well as snow skiing in more recent years. At the age of 19 he underwent a detailed cardiac work-up including right heart catheterization at another hospital. The findings at that time included a normal examination except for a grade III/VI blowing pansystolic murmur at the 4th left intercostal space. The chest x-ray disclosed a normal cardiac silhouette with normal pulmonary vascularity. The electrocardiogram disclosed right bundle branch block and left axis deviation. Cardiac catheterization disclosed systolic pressure of 30 mm. Hg. in the right ventricle and 23 in the pulmonary artery. There was O2 saturation of 78 per cent in the superior vena cava and 75 per cent in the inferior vena cava. In the high and mid right atrium O2 saturations ranged from 76 per cent to 80 per cent. Low in the atrium, just above the tricuspid valve, there was a small step-up of O2 saturation to 83 per cent and similar saturations were found in the right ventricle and pulmonary artery. The findings suggested a small shunt from left ventricle to right atrium of the type seen in the transitional form of atrio-ventricular communis. During the two weeks prior to the present event the patient and his roommate who was also a third year medical student, had undertaken to improve their physical conditioning by performing the Canadian Air Force series of calisthenic exercises.


1990 ◽  
Vol 11 (3) ◽  
pp. 156-158 ◽  
Author(s):  
Hiroyuki Aotsuka ◽  
Yoko Nagai ◽  
Manabu Saito ◽  
Hiroo Matsumoto ◽  
Tsunetaro Nakamura

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Naganur

Abstract Funding Acknowledgements Not applicable OnBehalf Not applicable 11 years boy with shortness of breath/easy fatigability. On examination obese, comfortable at rest, pulse : 80bpm, regular, normal JVP. Blood pressure : 170/100 in upper limb, 120/80 in lower limb. Mild cardiomegaly, normal S2, no S3/S4/click, harsh 4/6 ESM in left 3rd intercostal space, faint continuous murmur at the back. CXR : mild cardiomegaly, adequate pulmonary blood flow. ECG : sinus rhythm, normal QRS axis/intervals, biventricular hypertrophy. Echo : severe pulmonary stenosis (predominantly subvalvular, gradient 100mmHg) coarctation (gradient 50mmHg) preserved biventricular function. Cardiac CT : confirmed echo" findings, additional ? DCRV, anomalous RCA from left sinus. Cardiac MRI couldn"t yield more information. Hence, catheterization was performed. Pressure data : severe infundibular and mild valvular RVOT obstruction, normal PA pressure, severe coarctation. Oximetry : small L–>R shunt. RV angiogram : obstruction at sub-valvular/valvular levels, doming/reverse doming of pulmonary valve. LV angiogram : small subaortic VSD, L–>R. Aortic root angiogram : bicuspid aortic valve, no AR, anomalous RCA from left sinus, severe coarctation, no PDA. Plan : Single antihypertensive, surgical resection of infundibular RVOTO, pulmonary valvotomy, VSD closure, coarctation repair. Cath data Pressure in mm of Hg Right atrium (mean) 8 Right ventricle (apex) systolic 100 end diastolic 12 Right ventricle (outflow) systolic 60 end diastolic 12 Main pulmonary artery 25/10 (15) Left ventricle systolic 158 end diastolic 14 Ascending aorta 165/75 (140) Descending aorta 116/80 (100) Right Femoral artery 117/76 (98) Oximetry Superior vena cava 68% Inferior vena cava 74% Pulmonary artery 82% Aorta 99% Pulmonary vein 100% Qp/ Qs 1.6:1 Abstract P1485 Figure. CT/MRI/Cath


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hyun-Hwa Cha ◽  
Hae Min Kim ◽  
Won Joon Seong

Abstract Background Unilateral pulmonary artery discontinuity is a rare malformation that is associated with other intracardiac abnormalities. Cases accompanied by other cardiac abnormalities are often missed on prenatal echocardiography. The prenatal diagnosis of isolated unilateral pulmonary artery discontinuity can also be delayed. However, undiagnosed this malformation would have an effect on further prognosis. We report our case of a prenatal diagnosis of pulmonary atresia with ventricular septal defect and left pulmonary artery discontinuity. Case presentation A 33-year-old Asian woman visited our institution at 24 weeks of gestation because of suspected fetal congenital heart disease. Fetal echocardiography revealed a small atretic main pulmonary artery giving rise to the right pulmonary artery without bifurcation and the left pulmonary artery arising from the ductus arteriosus originating from the left subclavian artery. The neonate was delivered by cesarean section at 376/7 weeks of gestation. Postnatal echocardiography and multidetector computed tomography showed a right aortic arch, with the small right pulmonary artery originating from the atretic main pulmonary artery and the left pulmonary artery originating from the left subclavian artery. Patency of the ductus arteriosus from the left subclavian artery was maintained with prostaglandin E1. Right ventricular outflow tract reconstruction and pulmonary angioplasty with Gore-Tex graft patch was performed 25th day after birth. Unfortunately, the neonate died because of right heart failure 8 days postoperation. Conclusion There is a possibility that both pulmonary arteries do not arise from the same great artery (main pulmonary artery or common arterial trunk). Therefore, clinicians should check the origin of both pulmonary arteries.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.


Author(s):  
Jorge Cervantes-Salazar ◽  
Jose García-Montes ◽  
Henry Peralta-Santos ◽  
Diego Ortega-Zhindón ◽  
Juan Calderón-Colmenero

We present two patients with history of recurrent respiratory infections, fatigue and sweating. They were diagnosed with absence of connection between the main pulmonary artery (MPA) and right pulmonary artery (RPA) and bilateral ductus arteriosus, with the RPA originating from the ductus arteriosus. Treatment was approached with a hybrid strategy: percutaneous intraluminal angioplasty with a right intraductal stent and device closure of the left ductus arteriosus and followed by surgical reconstruction with interposition of a graft from RPA to MPA. Both patients had a favorable outcome.


CJEM ◽  
2009 ◽  
Vol 11 (06) ◽  
pp. 558-559
Author(s):  
Truptesh H. Kothari ◽  
Shivangi Kothari ◽  
Mahima Pandey ◽  
Harshit Khara ◽  
Nishant Dhungel

A 38-year-old man with a history of polyposis syndrome diagnosed 3 years previously, with poor compliance for follow-up, presented to the emergency department with symptoms of retrosternal chest pain associated with dizziness and shortness of breath. His blood pressure was 94/43 mm Hg, his pulse was 123 beats/min and he had an oxygen saturation of 84% on room air. The patient’s initial laboratory results showed a hemoglobin of 80 g/L and blood gas with a pH of 7.23. He had a normal chest radiograph and electrocardiogram, but had an elevated troponin I at 0.12 μg/L. He was given acetylsalicylic acid for suspicion of acute coronary syndrome. On physical examination, the patient was found to have right calf tenderness. With this finding and the presenting symptoms, he underwent computed tomography angiography (CTA) of the chest. The chest CTA showed a massive saddle embolus with a filling defect completely occluding the right pulmonary artery and extending through the main pulmonary artery segment to involve the left pulmonary artery. There were also diffuse filling defects involving bilateral pulmonary segmental arteries (Fig. 1 and Fig. 2). The patient received alteplase and underwent a workup for a hypercoagulable state. His workup revealed positive anticardiolipin antibodies and factor V Leiden. The Doppler ultrasound of his lower extremities showed an extensive thrombus measuring more than 6 cm extending in the right superficial femoral vein. The patient was then referred for placement of an inferior vena cava filter.


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