Author + information
- Received March 30, 2017
- Accepted April 6, 2017
- Published online July 3, 2017.
- Gurpreet S. Dhillon, MD and
- Athar M. Qureshi, MD∗ ()
- Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas
- ↵∗Address for correspondence:
Dr. Athar M. Qureshi, CE Mullins Cardiac Catheterization Laboratories, Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Baylor College of Medicine, 6621 Fannin Street, MC 19345C, Houston, Texas 77030.
A 3-year-old female patient with T-lymphoblastic lymphoma undergoing chemotherapy was seen for outpatient oncology clinic follow-up, and there was difficulty accessing her port. Chest radiography showed a fragmented Port-A-catheter (AngioDynamics, Latham, New York) with the distal ends both located in the right ventricle. This gave the intracardiac fragment a striking characteristic shape of a “cupid’s heart” on posterior-anterior (Figure 1) and lateral (Figure 2) chest x-ray projections.
The patient was taken to the catheterization laboratory urgently for removal of the embolized catheter fragment. Using percutaneous access, a pigtail catheter was first advanced through a femoral venous sheath and used to relocate the dislodged fragment to the inferior vena cava (to prevent damage to the tricuspid valve leaflets from snaring within the right ventricle). A snare catheter was then used to retrieve the fragment from the body.
Although dislodgement of a Port-A-catheter is relatively rare, it does occur at an incidence reported at about 0.1% (1). Significant morbidity can occur without removal of embolized intravascular foreign bodies (2–4). Percutaneous retrieval of intravascular foreign objects is the gold standard for initial intervention, as it can be performed safely with success rates reported between 71% and 100% (2,4).
Both authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 30, 2017.
- Accepted April 6, 2017.
- 2017 American College of Cardiology Foundation