Journal of Surgery and Surgical Research 

Panel A: Anterior projection of the foreign body. Panel B: Lateral image of the radio-opaque linear object. Panel C: CVC line in situ visible via right atriotomy. Panel D: The central line frozen shape well demonstrates the superior vena cava-right atrium continuity.

Central Venous Catheter Impacted into the Tricuspid Annulus over a Quarter Century

A 58-year-old woman was referred for elective coronary bypass graft surgery (CABG). As an incidental finding, the coronary angiogram showed a radio-opaque linear foreign body in the superior vena caval-right atrial region; additionally to a significant flow-limiting multivessel coronary artery disease (Panels A, B). The nature of the foreign body was initially unclear; the patient did not give a history of penetrating chest trauma or other major diseases. Further anamnestic review revealed a suicidal attempt 25 years before, which lead to a short intensive care stay. The patient underwent a conventional triple vessel CABG. After opening the right atrium, a fractured old-fashioned central venous cannula (CVC) was found being impacted with the tip into the tricuspid annulus; the curvature accurately shaped the route through superior vena cava to the tricuspid valve (Panels C, D). Following removal of the foreign body the patient had an uneventful postoperative course.

 http://www.peertechz.com/Surgery-Surgical-Research/JSSR-1-107.php  




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