Right atrium thrombosis in patients on hemodialysis

Rotellar, C; Sims, Scott C.; Freeland, Judy; Korba, John; Jessen, Mark; Taylor, Alan

doi:10.1016/s0272-6386(96)90110-9

Cited by 24 publications

(18 citation statements)

References 3 publications

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“…Cases of large right atrial thrombi in the absence of any symptoms have sporadically been observed. 7 It is likely that right atrial thrombi are underreported among hemodialysis patients because of the potential absence of clinical symptoms (as in our case report), the failure to consider the diagnosis in symptomatic patients, the diagnostic limits of transthoracic echocardiography, and the spontaneous resolution of thrombi. 8 In this case report, we describe a patient in which a malfunctioning dialysis catheter related to right atrial thrombosis was observed in association with a patent foramen ovale (PFO).…”

Section: Introductionmentioning

confidence: 77%

Right atrial thrombus in an asymptomatic hemodialysis patient with malfunctioning catheter and patent foramen ovale

Laecke¹,

Dhondt²,

Sutter³

et al. 2005

Hemodialysis International

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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.

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Section: Introductionmentioning

confidence: 77%

Right atrial thrombus in an asymptomatic hemodialysis patient with malfunctioning catheter and patent foramen ovale

Laecke¹,

Dhondt²,

Sutter³

et al. 2005

Hemodialysis International

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“…Transesophageal echocardiography has advantages like detecting small thrombi beyond the resolution of TTE, identifying sessile thrombi and accurate determination of the size and the age of the thrombi 9,10 . MRI revealed RAT in those TTE was uninformative 1,11,12 . It could be a useful alternative to TEE 13 …”

Section: Treatment Outcomesmentioning

confidence: 99%

“…However, removal of the catheter does not reduce the risk of serious complications 13 . Also there were 4 reports of successful management of RAT without the removal catheter 3,12,17 . Out of 48 patients (Table 1) with a CVC‐related RAT, all 4 patients who were not treated (either surgery or conservative) had expired.…”

Section: Treatment Outcomesmentioning

confidence: 99%

Right atrial thrombus due to internal jugular vein catheter

Ram

Swarnalatha

Rakesh

et al. 2009

Hemodialysis International

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Right atrial thrombus is rare complication of hemodialysis central venous catheter. Literature survey revealed 49 documentations of right atrial thrombus due to a central venous catheter. We report a 58-year-old type 2 diabetic, hypertensive, end-stage renal disease patient, who 2 months after initiation of hemodialysis through a right internal jugular vein catheter, developed clinical features suggestive of pulmonary thromboembolism. An echocardiography revealed presence of a serpentine thrombus in right atrium. The internal jugular vein catheter was removed and unfractionated heparin was initiated. At the end of 6 weeks he was symptom free. We compared conservative treatment with surgery for RAT. Conservative management with central venous catheter removal and anticoagulation therapy is not inferior to the surgery.

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“…Thrombosis is a common cause of catheter malfunction and is often the result of long‐term catheter use (3–5). It can present clinically as inadequate blood flow rate, pulmonary or systemic (paradoxical) embolization, or a mass within the right atrium (6–9). Early impairment of the extracorporeal blood flow rate is more often related to catheter tip malposition or other technical problems rather than thrombosis (10).…”

Section: Thrombotic Complicationsmentioning

confidence: 99%

UNRESOLVED ISSUES IN DIALYSIS: Long‐Term Management of the Tunneled Venous Catheter

Liangos

Gul

Madias

et al. 2006

Seminars in Dialysis

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Despite their propensity for significant complications, tunneled central venous catheters have become a common means of vascular access in the United States for patients requiring maintenance hemodialysis for end-stage renal disease (ESRD). Reasons for their use include advanced patient age, peripheral vascular disease (arterial and venous), late referral for creation of vascular access, and more importantly, the lack of an interdisciplinary service line on vascular access among vascular surgeons, radiologists, and nephrologists. This review article summarizes complications commonly encountered in dialysis patients who use tunneled central venous catheters for vascular access-mainly thrombosis, stenosis, and infection. Special attention is given to novel approaches for the prevention of catheter-associated infections. Effective prevention and timely treatment of common catheter-associated complications can reduce the substantial morbidity associated with the use of these devices. However, these measures should not detract from the goal of avoiding or limiting the long-term use of catheters, thereby optimizing vascular access management by ensuring the timely availability of functioning arteriovenous fistulas.

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Right atrium thrombosis in patients on hemodialysis

Cited by 24 publications

References 3 publications

Right atrial thrombus in an asymptomatic hemodialysis patient with malfunctioning catheter and patent foramen ovale

Right atrial thrombus in an asymptomatic hemodialysis patient with malfunctioning catheter and patent foramen ovale

Right atrial thrombus due to internal jugular vein catheter

UNRESOLVED ISSUES IN DIALYSIS: Long‐Term Management of the Tunneled Venous Catheter

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