[Right atrial thrombus--a complication of central venous catheters].
We describe the development, in three days, of a pediculate mass hanging on the right atrial lateral wall in a 39-year-old woman with a subclavian venous catheterization. She was a current smoker and alcoholic but without drug addict. The hypothesis of a non valvular right atrial infective endocarditis was considered at first, but subsequent events directed the diagnosis towards a thrombus, which was resorbed by heparin. We discuss the incidence, the complications, the treatment and the differential diagnosis of thrombus caused by a central venous catheter. The prevention of right atrial thrombus caused by a central venous catheter depends on the position of the central venous catheter tip, either in the superior vena cava or at the superior vena cava-right atrium junction. A more distal position is a frequent source of thrombotic and embolic complications.
Service de cardiologie A, hôpital Arnaud de Villeneuve, Montpellier.
A
A
Bortone
P
P
Corne
J C
JC
Macia
L
L
Landreau
V
V
Moulaire
F
F
Leclercq
O
O
Jonquet
D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D013350:Subclavian Vein