Paradoxical emboli after central venous catheter removal.
Central venous catheters are widely used in intensive medicine to provide blood product, nutritional and antibiotic support. A 45-year-old man with an unsuspected patent foramen ovale underwent a bone marrow allograft for poor-risk acute lymphoblastic leukaemia. His venous line was removed because of probable infection, and he simultaneously sustained a myocardial infarct and a cerebrovascular accident. He made a good recovery from both, but subsequently died of relapsed disease. Appropriate pre-transplant screening investigations are discussed, and the differential diagnosis of this complication in the bone marrow transplant setting.
Zuha
R
R
Department of Medical Oncology, The Royal Marsden NHS Trust, Sutton, Surrey, UK.
Price
T
T
Powles
R
R
Treleaven
J
J
D016026:Bone Marrow Transplantation; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D019320:Embolism, Paradoxical / Q000209:etiology*; D006344:Heart Septal Defects, Atrial / Q000473:pathology; D006801:Humans; D007239:Infections; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D020521:Stroke / Q000209:etiology