Peripherally Inserted Central Catheter Placement in a Total Artificial Heart Recipient

Abstract

Bedside insertion of a peripherally inserted central catheter (PICC) in a recipient of a total artificial heart is contraindicated due to the possible catastrophic event of the catheter jamming the total artificial heart pump and creating a stoppage of the pump, and consequently, death of the patient. A patient with a total artificial heart suffered complications intraoperatively and postoperatively that necessitated removal of the vascular access devices from the patient s bilateral femoral veins. The patient was deemed hemodynamically unstable and unsafe to travel to interventional radiology for vascular access placement. In a multidisciplinary effort, the vascular access team, intensivists, and the cardiothoracic surgical team worked together to use best practice for the bedside placement of a PICC safely and without complications. Though not the ideal conditions and scenario for a PICC placement, this case study describes a method of PICC line placement that can be used when limited options are available.