World journal of nephrology · 2026
Video-assisted minithoracotomy for right atrial hemodialysis catheter placement after vascular access exhaustion: Two case reports.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Navarro-Zambrano Gutenberg C, Pozo-Obando Jorge W, Espinoza de Los Monteros-Duche Rommel O, Osorio-Chuquitarco Washington X, Huertas-Garzón Jorge W, León-Sosa Amaury, Cabezas-Tapia Henry G, Echevarría-Frutos Isabel
Аннотация
BACKGROUND: End-stage renal disease (ESRD) continues to increase worldwide, and long-term hemodialysis requires reliable vascular access. Progressive exhaustion of peripheral and central venous routes poses a major therapeutic challenge and may necessitate unconventional surgical strategies.
CASE SUMMARY: We report two patients with ESRD and complete depletion of conventional vascular access who underwent direct right atrial hemodialysis catheter placement via video-assisted thoracoscopic minithoracotomy. The first patient was a 68-year-old man with extensive central venous thrombosis and multiple failed catheterizations. The second was a 32-year-old woman with lupus-related ESRD, recurrent catheter infections, and previous thoracic surgeries. In both cases, intra-atrial catheter placement was successfully achieved under direct thoracoscopic visualization. Both patients experienced uneventful postoperative courses, immediate catheter functionality, and sustained hemodialysis efficacy during an eight-month follow-up period.
CONCLUSION: Video-assisted minithoracotomy is a safe, effective salvage approach for right atrial hemodialysis catheter placement in patients with exhausted vascular access.
CASE SUMMARY: We report two patients with ESRD and complete depletion of conventional vascular access who underwent direct right atrial hemodialysis catheter placement via video-assisted thoracoscopic minithoracotomy. The first patient was a 68-year-old man with extensive central venous thrombosis and multiple failed catheterizations. The second was a 32-year-old woman with lupus-related ESRD, recurrent catheter infections, and previous thoracic surgeries. In both cases, intra-atrial catheter placement was successfully achieved under direct thoracoscopic visualization. Both patients experienced uneventful postoperative courses, immediate catheter functionality, and sustained hemodialysis efficacy during an eight-month follow-up period.
CONCLUSION: Video-assisted minithoracotomy is a safe, effective salvage approach for right atrial hemodialysis catheter placement in patients with exhausted vascular access.