Santral venöz kateterizasyon sonrası sağ atriumda ve pulmoner arter kateteri çevresinde trombüs
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Date
2009-04-06
Authors
Korfalı, Gülsen
Canbulat, Atilla
Gören, Suna
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Kateterle ilişkili trombüs, santral venöz kateterlerin önemli komplikasyonlarındandır. Trombüs riski, kateterin uygulandığı bölge ve kalış süresine göre değişmektedir. Santral venöz kateterizasyon sonrası pulmoner arter kateteri çevresinde ve sağ atriumda trombüs saptanan bir olguyu sunduk. Mitral kommissürotomi operasyonu uygulanan olgu, 2 ay sonra mitral valv replasmanı için yeniden operasyona alındı. İlk operasyon sırasında sağ internal jugular venden santral venöz kateter yerleştirilmiş ve operasyondan 4 gün sonra kateter çıkarılmıştı. İkinci ameliyat sırasında herhangi bir güçlükle karşılaşılmadan aynı juguler venden santral venöz kateter ve pulmoner arter kateteri yerleştirildi. Kardiyopulmoner baypas sırasında sağ atriumda serbest trombüs parçaları ve pulmoner arter kateterinin çevresinde trombüs saptandı. Trombüsler temizlendi ve operasyon komplikasyonsuz tamamlandı. Santral kateter yerleştirilecek vene daha önce kateterizasyon uygulanmış ise trombüs olasılığı düşünülmeli ve kateterizasyon öncesi venöz ultrasonografi yapılmalıdır.
Vascular thrombosis is a major complication associated with the use of central venous catheters, and its’ risk varies according to the site of insertion and duration of catheterization. We present a case with thrombus in the right atrium and around the pulmonary artery catheter after central venous catheterization. The case who had undergone open mitral commissurotomy for mitral stenosis, underwent re-do surgery for mitral valve replacement 2 months later. During the first operation, a central venous catheter was inserted into the right internal jugular vein and was removed 4 days after the operation. During the second operation, a central catheter was inserted into the same vein, and pulmonary artery catheter was inserted without any difficulty. During cardiopulmonary bypass, a thrombus was seen around the pulmonary artery catheter and free thrombus particles were present in the right atrium. All thrombus particles which were seen in the right atrium were removed and the operation was completed without any complication. If the choosen vein for central catheterization is used before, the possibility of a thrombus should be considered, and venous ultrasonography should be performed before the catheterization.
Vascular thrombosis is a major complication associated with the use of central venous catheters, and its’ risk varies according to the site of insertion and duration of catheterization. We present a case with thrombus in the right atrium and around the pulmonary artery catheter after central venous catheterization. The case who had undergone open mitral commissurotomy for mitral stenosis, underwent re-do surgery for mitral valve replacement 2 months later. During the first operation, a central venous catheter was inserted into the right internal jugular vein and was removed 4 days after the operation. During the second operation, a central catheter was inserted into the same vein, and pulmonary artery catheter was inserted without any difficulty. During cardiopulmonary bypass, a thrombus was seen around the pulmonary artery catheter and free thrombus particles were present in the right atrium. All thrombus particles which were seen in the right atrium were removed and the operation was completed without any complication. If the choosen vein for central catheterization is used before, the possibility of a thrombus should be considered, and venous ultrasonography should be performed before the catheterization.
Description
Keywords
Santral venöz kateter, Trombüs, Thrombus, Central venous catheter
Citation
Girgin, N. K. vd. (2009). ''Santral venöz kateterizasyon sonrası sağ atriumda ve pulmoner arter kateteri çevresinde trombüs''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 35(1), 55-57.