The Turkish Journal of Pediatrics
2009 , Vol 51 , Num 5
Percutaneous Transcatheter Retrieval of Intracardiac Central Venous Catheter Fragments in Two Infants Using Amplatz Goose Neck Snare
Sections of 1Pediatric Cardiology, 2Pediatric Oncology, and 3Pediatric Allergy and Immunology, Department of Pediatrics,
Ankara University Faculty of Medicine, Ankara, Turkey
Central venous catheter (CVC) fracture with embolization is a serious and
rare complication, and few cases have been reported in children. Catheter
fragments may cause cardiac perforation, arrythmias, pulmonary embolism, and
sepsis. We report the successful retrieval of intracardiac CVC fragments by
percutaneous transcatheter technique in two infants, aged 8 and 15 months.
Double-lumen 7 French Hickman CVCs were accidentally fractured during their
removal. Chest radiographs of the two patients revealed migrated intracardiac
catheter fragments extending from the superior vena cava (SVC) to the right
atrium and from the SVC to the right ventricle, respectively. The procedure
was performed under ketamine anesthesia and fluoroscopic guidance using
a percutaneous femoral vein approach. Nitinol Amplatz Goose Neck™ snares
(10 mm in diameter) were used to successfully retrieve the catheter fragments
without any complication. Percutaneous transcatheter retrieval of catheter
fragments using Goose Neck snare is a safe and successful technique and
can be chosen before resorting to surgery, which has potential risks related
to general anesthesia, thoracotomy and cardiopulmonary bypass.
Keywords :
catheter fracture, dislodged catheter, percutaneous retrieval, transcatheter
retrieval, goose neck snare.