Journal of pediatric surgery · 2008
Thoracoscopic-assisted central line placement for a thrombosed superior vena cava.
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Alqahtani Aayed R
Аннотация
BACKGROUND: In children who require prolonged and multiple venous catheterizations, the superior vena cava and iliofemoral veins may become occluded, making central venous access a difficult challenge. We report an innovative technique of catheter insertion percutaneously from the neck into the right atrium traversing a thrombosed superior vena cava using video-assisted thoracoscopic surgery.
METHODS: Two children with irreversible intestinal failure had 4 central venous accesses insertions using the above-mentioned technique. Both had occluded major central veins after multiple catheterizations. An interventional radiologist and cardiologist failed to establish a central venous access in both patients.
RESULTS: A 9-year-old boy has a long-term catheter functioning for 8 months, and in an 18-month-old girl, the line was removed accidentally 6 weeks from its insertion and 2 months later for a line leak. It was then reinserted each time using the same technique.
CONCLUSION: This technique of catheter placement into the right atrium using video-assisted thoracoscopic surgery when other conduits are unavailable can be lifesaving in children depending on total parenteral nutrition.
METHODS: Two children with irreversible intestinal failure had 4 central venous accesses insertions using the above-mentioned technique. Both had occluded major central veins after multiple catheterizations. An interventional radiologist and cardiologist failed to establish a central venous access in both patients.
RESULTS: A 9-year-old boy has a long-term catheter functioning for 8 months, and in an 18-month-old girl, the line was removed accidentally 6 weeks from its insertion and 2 months later for a line leak. It was then reinserted each time using the same technique.
CONCLUSION: This technique of catheter placement into the right atrium using video-assisted thoracoscopic surgery when other conduits are unavailable can be lifesaving in children depending on total parenteral nutrition.