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[Retrieval of intravascular catheter fragment remaining for 15 years--a case report]
1Department of Cardiovascular Surgery, Miyazaki Prefectural Hospital, Japan.
Insights
A 66-year-old woman had a Swan-Ganz Thermodilution catheter removed after 15 years. The degraded catheter was successfully retrieved, highlighting the importance of careful surgical procedures and patient monitoring.
Area of Science:
- Cardiovascular Surgery
- Medical Device Retrieval
- Patient Safety
Background:
- A 66-year-old female patient underwent aortic valve replacement, mitral valve replacement, and tricuspid annuloplasty.
- A Swan-Ganz Thermodilution catheter had been retained in the superior vena cava and right atrium for 15 years post-surgery.
Observation:
- The retained catheter was successfully retrieved after 15 years without complications such as contamination or embolism.
- The extracted catheter exhibited stiffness, indicative of material degradation over the prolonged period.
- A surgical thread from a previous left atrial closure was identified as the likely cause for the catheter's retention.
Findings:
- Successful retrieval of a long-term retained Swan-Ganz Thermodilution catheter was achieved.
- Catheter material degradation occurred over 15 years of in-situ retention.
- Surgical technique, specifically the use of a closing thread, can contribute to foreign body retention.
Implications:
- Emphasizes the critical importance of meticulous surgical technique to prevent retained foreign bodies.
- Suggests that long-term retained catheters may become integrated with vascular intima, posing bleeding risks during retrieval.
- Recommends using extracorporeal circulation for retrieval of long-term retained catheters or those post-open-heart surgery to mitigate bleeding risks.
Abstract:
A 66-year-old woman was operated on aortic valve replacement, mitral valve replacement, and tricuspid annuloplasty. Retrieval of remaining Swan-Ganz Thermodilution catheter in the superior vena cava and the right atrium for 15 years was also made. Fortunately, contamination and embolism have not occurred for 15 years. Extracted catheter showed to be stiff due to the degradation. It was suggested that the cause of remaining was the thread for closing the left atrium on the previous operation. The explanation to patient and one's recognition are most important. We recommend that retrieval of remaining catheter for a long time and/or after open heart surgery should be made under extracorporeal circulation because that remaining catheter may be involved with the intima, and preventing from bleeding.