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Septic atrial thrombosis. A potentially lethal complication of Broviac catheters in infants
Insights
Septic atrial thrombosis from Broviac catheters can be fatal, even with modern Silastic catheters. Early diagnosis with echocardiography and aggressive treatment, including surgery, led to full recovery in three infants.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Silastic catheters reduce but do not eliminate catheter-related thrombosis and infection in long-term parenteral nutrition.
- Broviac catheters are commonly used for long-term parenteral nutrition.
- Catheter-related complications remain a significant concern.
Observation:
- Three infants developed septic atrial thrombosis secondary to Broviac catheter use.
- One infant experienced severe complications including pulmonary embolism and Budd-Chiari syndrome.
- Echocardiography proved crucial for diagnosing this potentially fatal condition.
Findings:
- Septic atrial thrombosis is a serious complication associated with Broviac catheters.
- Aggressive treatment, including open-heart thrombectomy, is effective.
- Prompt diagnosis and intervention are vital for patient survival and recovery.
Implications:
- Highlights the persistent risk of thrombosis with central venous catheters.
- Emphasizes the importance of echocardiography in diagnosing complex catheter-related complications.
- Demonstrates the efficacy of aggressive surgical management for severe septic atrial thrombosis in infants.
Abstract:
Even though the use of Silastic catheters for long-term parenteral nutrition has decreased the incidence of catheter-related thrombosis and infection, these serious complications still occur. We describe three infants with septic atrial thrombosis secondary to use of Broviac catheters. One of the infants had pulmonary embolism and Budd-Chiari syndrome. The use of echocardiography in the diagnosis of this potentially fatal complication and aggressive treatment--which included open heart removal of thrombi--are discussed. The three infants recovered fully from this complication.