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Semin intervent Radiol 2023; 40(03): 304-307
DOI: 10.1055/s-0043-1769745
Review Article

Malposition of a Femoral Tunneled Dialysis Catheter through a Patent Foramen Ovale

Anthony Finnay Blackburn
1   Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
,
Gina P. Landinez
1   Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
,
Robert K. Kerlan
1   Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
,
R. Peter Lokken
1   Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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Abstract

Patent foramen ovale (PFO) is a common congenital abnormality of high prevalence in adults. Its clinical significance is magnified in a right-to-left shunt, where paradoxical embolism can have catastrophic outcomes involving the brain, heart, mesenteric circulation, or extremities. Right-to-left shunting through a PFO is caused by increased right atrial pressure, as seen in the setting of pulmonary artery hypertension or pulmonary embolism. This case highlights the relevance of central venous catheter placement in the setting of a PFO. While the patient did not experience clinical sequelae from line placement, she was at high risk for paradoxical embolus. Recognizing the possibility of a PFO during central venous catheter placement, especially in the setting of increased right pressures, should be a consideration of all interventional radiologists.

Keywords

tunneled dialysis catheter - malposition - patent foramen ovale - right-to-left shunt


Publication History

Article published online:
20 July 2023

© 2023. Thieme. All rights reserved.

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