Spontaneous migration of a central line catheter into the heart

Abstract EN

Background: Spontaneous migration of central line catheter into the heart is extremely rare complication after initial placement.

Objective: To present two cases with unusual central venous line-related complication.

Design: Retrospective review.

Setting: Surgical and Pediatric Oncology Departments, Salmaniya Medical Complex, Kingdom of Bahrain.

Method: The charts of two patients with spontaneous migration of port-a-cath catheter into the heart presented to the surgical department (between January 2006 to March 2007) were reviewed.

Result: The first patient is 12 years old female, a known case of acute lymphoblastic leukemia (ALL) and Down's syndrome, presented with failure to aspirate the central line after 3 months of port-a-cath catheter insertion.

The second patient is 7 years old male, known case of acute lymphoblastic leukemia presented with non-functioning line after 5 months of insertion of port-a-cath catheter.

Chest x-rays of both patients confirmed the migration of the catheter into the heart.

The catheter in the first case was removed by percutaneous retrieval by loop-snare technique, and in the second case the catheter was removed by open neck surgery.

Conclusion: Spontaneous migration of port-a-cath catheter into the heart is a rare complication.

Chest x-ray is essential to provide early detection and management of migrated catheter.

Early diagnosis and removal of the catheter is the rule in all cases.