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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Echocardiographic detection of a retained left atrial catheter
Insights
A retained left atrial catheter caused a cerebral embolism in a cardiac surgery patient. Echocardiography diagnosed the retained catheter, necessitating surgical removal and highlighting the need for baseline echocardiograms in similar cases.
Area of Science:
- Cardiovascular Surgery
- Diagnostic Imaging
- Neurosurgery
Background:
- Cardiac surgery patients often require indwelling catheters for hemodynamic monitoring.
- Accidental retention of these catheters can lead to serious complications.
- Early diagnosis and intervention are crucial for patient outcomes.
Observation:
- A retained left atrial catheter was suspected after neurological signs of cerebral embolism appeared.
- Echocardiography confirmed the catheter's presence within the left atrium.
- Repeat thoracotomy was required for the catheter's removal.
Findings:
- The retained left atrial catheter was the source of the cerebral embolism.
- Prompt echocardiographic evaluation was key to diagnosing the retained catheter.
- Surgical removal of the retained catheter resolved the complication.
Implications:
- Baseline echocardiograms are recommended for cardiac surgical patients with indwelling left atrial catheters.
- Echocardiography plays a vital role in diagnosing retained catheter complications.
- Preventing catheter retention and ensuring complete removal are critical in postoperative care.
Abstract:
An 18-year-old woman underwent the repair of traumatic lacerations of the mitral valve, tricuspid valve, and interventricular septum. At the time of surgery, an indwelling left atrial catheter was placed for postoperative hemodynamic manangement. An attempt to remove the catheter completely several days following surgery was unsuccessful, but it was initially assumed by the surgeon that the tip of the catheter had been withdrawn from the left atrium. When the patient developed neurologic signs suggesting a cerebral embolism, an echocardiogram was performed. Echo demonstration of the catheter in the left atrium led to repeat thoracotomy for removal of the retained line. Baseline echocardiograms are indicated in cardiac surgical patients with indwelling left atrial catheters and echo study can be diagnostic if catheter retention occurs.
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