Медицинские имплантаты и хирургия

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Large Right Atrial Thrombus Caused by a Central Venous Catheter Necessitating Open Heart Surgery

Kukucka Sadiq

In clinical practise, central venous catheters are frequently employed. The incidence of CVC-related right atrial thrombosis varies, but when it occurs, there is an 18% mortality risk in hemodialysis patients and a greater than 40% risk in non-hemodialysis patients. For the development of CRAT, various pathogenic processes have been proposed, including mechanical irritation of the cardiac wall, intraluminal clot propagation, hypercoagulability, and hemodynamics of the right atria. CRAT may present asymptomatically or with one of the consequences of CRAT such as pulmonary embolism, systemic embolism, infected thrombi, or hemodynamic compromise. There are no recognised CRAT therapy guidelines. A 59-year-old asymptomatic male was effectively treated with open cardiac surgery after medical treatment for a big CRAT identified during a preoperative examination for a kidney transplant failed. Our case demonstrates that detecting CRAT early may result in a better outcome than waiting until severe consequences emerge.