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Purpose: To determine whether radiographic heart morphology and echocardiography findings were associated with early central venous catheter (CVC) failure in hemodialysis patients. Materials & Methods: All hemodialysis catheter insertions between 1996-2007 were captured in a combined nephrology radiology database. Factors were identified that may be associated with early catheter failure. Factors examined included: echocardiography findings, radiographic evidence of flattened heart border, boot-shaped heart and left ventricular hypertrophy as well as patient comorbidities and peri-procedural characteristics. Results: Of the 132 CVC failures in 132 patients, 67 (50.8%) occurred within 30 days of insertion. Early CVC failure was more likely to occur in patients who had insertions from the left side (?2, p = 0.020) and with catheter tip position outside the cavoatrial junction (?2, p = 0.040). CVC failure rates also differed by year of placement (?2, p < 0.01), if the patient had evidence of left ventricular hypertrophy (?2, p = 0.030), left systolic dysfunction (?2, p = 0.030), and hypokinetic right wall mechanics (?2, p < 0.01). Conclusion: Radiographic findings of left ventricular hypertrophy and echocardiography findings of left systolic dysfunction were found to be associated with early failure.

Chest Radiography and Echocardiography Predictors of Early Hemodialysis Catheter Dysfunction