Port implantation into the aortic arch: an unusual complication requiring urgent cardiac surgery

A port-a-cath was accidentally inserted into an arterial vessel of a 78-year-old woman. Chest X-ray was suggestive for aortic placement (Fig. 1A) being confirmed by computed tomography (Fig. 1B). The patient was immediately scheduled for surgery, which could be performed without cardiopulmonary bypass (Fig. 1C and D). The patient made a swift recovery. Fig. 1. (A) Port-a-cath as shown in the preoperative X-ray. Arrows indicate course of catheter. (B) 3D-reconstruction of computed tomography scan (left-posterior view) displays the port-a-cath (1) penetrating the aortic arch between the origin of the left carotid (2) and left subclavian artery (3). (C and D) Intra-operative view of the Port-a-cath before (C) and after removal (D) from the aortic arch. After sternotomy and extrapericardial exposure of the aortic arch, two purse string sutures were placed on the aortic arch around the device which allowed port removal without bleeding.