Major right atrial thrombus related to central venous catheter positioning

Abstract

We report the case of a 44-year-old woman who developed a thrombus of life-threatening size in the right atrium. The thrombus had formed around the catheter tip of her tunnelled central venous catheter, which was inserted for haemodialysis. Because of the size of the thrombus and the high risk of pulmonary embolism, surgical thrombectomy was performed. Because of an increasing incidence and usage period of tunnelled central venous catheters, the likelihood of catheter-related complications rises. Contributing factors need to be identified and reduced, especially in long-term catheter-dependent patients. One of those risk factors might be the exact position of the catheter tip.