[Fracture and embolization of a central venous port catheter without prior compression between the clavicle and the 1st rib].

Abstract

A central venous port catheter inserted infraclavicularily via the subclavian route may be compressed by the clavicle and the adjacent first rib. It's appearance on chest x-ray has been previously described as the 'pinch-off phenomenon' and requires the removal of the catheter due to a significant risk of fracture. We report the case of a catheter fracture without prior evidence of pinch-off. The free catheter fragment was embolized into the right atrium and caused pericardial effusion. Percutaneous removal of the fragment was attempted but failed and thus open heart surgery with a cardiopulmonary bypass was required. The myocardial lesion caused by the catheter was sutured.