Catheter-related right atrial thrombosis: a case series

Abstract

Objective: Complications associated with central venous catheters (CVC), such as right atrial thrombosis, are a common but poorly recognized complication. Therefore, it is important to describe the follow-up and the various forms of treatment along with the responses associated with it. Delayed approach leads to a higher rate of complications, morbidity, and mortality. This case series presents three patients with catheter-related thrombosis. Case Presentation: The initial patient was a 55-year-old male with short bowel syndrome who required parenteral nutrition through a CVC. Unfortunately, this was complicated by thrombosis. During the approach, the patient's condition remained stable, and he was managed with anticoagulation, with an adequate response. The 2nd case involved a 56-year-old woman with chronic kidney disease (CKD) who underwent renal replacement therapy (RRT) with hemodialysis. However, her condition deteriorated due to thrombus formation in the Mahurkar catheter, resulting in obstruction of the tricuspid valve. Consequently, she underwent surgical thrombectomy, which yielded a favorable outcome. The 3rd patient was a 31-year-old male with CKD and RRT via hemodialysis, complicated by thrombus formation in the Mahurkar catheter. He remained hemodynamically stable and was treated with anticoagulation therapy alone, with a favorable resolution. Conclusions: Despite the absence of a uniform approach to treatment, the selection of an appropriate strategy and the management of these patients must be based on the experience and expertise of the medical center, the characteristics of the thrombus, and the patient's hemodynamic status. It is therefore essential to highlight the use of various treatments in our series, which were adapted to the characteristics of the cases and led to satisfactory clinical outcomes.

Keywords

• venous catheterization
• right atrium
• thrombosis
• management
• surgery
• anticoagulation