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Right atrial thrombus in an asymptomatic hemodialysis patient with malfunctioning catheter and patent foramen ovale
Author(s) -
Van Laecke S.,
Dhondt A.,
De Sutter J.,
Vanholder R.
Publication year - 2005
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2005.01137.x
Subject(s) - medicine , hemodialysis , patent foramen ovale , catheter , hemodialysis catheter , surgery , arteriovenous fistula , thrombus , dialysis catheter , asymptomatic , dialysis , population , complication , fistula , cardiology , percutaneous , environmental health
The creation of an accurate functioning arteriovenous fistula has been a long‐lasting problem in the hemodialysis setting. In spite of recent guidelines and largely because of the old age of the current dialysis population and a high incidence of diabetes mellitus, atherosclerosis, and related vascular problems, it is not always possible to create an adequate fistula. In that case, long‐term tunneled indwelling central vein catheters are a frequently used alternative. Of the many possible complications related to venous access in hemodialysis patients, catheter dysfunction is the most prevalent. We report a 23‐year‐old female hemodialysis patient in whom such malfunctioning was followed by echocardiography that revealed a large right atrial thrombus (RAT) in close contact to the tip of a long‐term indwelling catheter in the presence of a patent foramen ovale. Although RAT is a rare complication in hemodialysis patients, it has very specific therapeutic implications. The present patient underwent a successful surgical atrial thrombectomy. Our experience underscores that in cases of malfunctioning catheter, echocardiographic screening is mandatory.