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Case Reports
. 2023 Apr;64(4):351-355.

Rapport de cas Surgical retrieval of a migrated vascular access port catheter in a dog

Sheena W Wong  1 , Aylin Atilla  1 , Jasmine Gu  1 , Vivian C Fan  1 , Kathleen A Linn  1
Affiliations
Case Reports

Rapport de cas Surgical retrieval of a migrated vascular access port catheter in a dog

Sheena W Wong et al. Can Vet J. 2023 Apr.

Abstract
in English, French

A 4-year-old spayed female Boston terrier was diagnosed with a suspected meningioma involving the optic chiasm and resulting in vision loss. A vascular access port (VAP) was placed in the left medial saphenous vein to facilitate frequent anesthetic episodes for radiation therapy. Five days after placement, the VAP was nonfunctional with the silicone catheter still intact. During VAP removal surgery, it was discovered that the silicone catheter had migrated. Intraoperative focal ultrasound could not identify the migrated catheter within the pelvic limb. Thoracic computed tomography identified the migrated catheter retroflexed onto itself in the cranial vena cava and extending into the right pulmonary artery as it passed through the right side of the heart. The dog underwent a hybrid surgical approach consisting of an endovascular retrieval forceps technique with median sternotomy for intravenous non-radiopaque foreign body removal. Postoperative complications, including regurgitation and left atrial thrombus, were managed. The left atrial thrombus persisted for 10 mo after the hybrid surgery. Key clinical message: A hybrid approach consisting of an endovascular retrieval forceps technique with median sternotomy was effective in removing an intravenous non-radiopaque foreign body in a dog.

Récupération chirurgicale d’un cathéter de port d’accès vasculaire migré chez un chien. Une femelle terrier de Boston stérilisée âgée de 4 ans a reçu un diagnostic de méningiome présumé impliquant le chiasma optique et entraînant une perte de vision. Un port d’accès vasculaire (VAP) a été placé dans la veine saphène médiale gauche pour faciliter les épisodes fréquents d’anesthésie pour la radiothérapie. Cinq jours après la mise en place, le VAP était non fonctionnel avec le cathéter en silicone toujours intact. Au cours de la chirurgie de retrait du VAP, il a été découvert que le cathéter en silicone avait migré. L’échographie focale peropératoire n’a pas pu identifier le cathéter migré dans le membre pelvien. La tomodensitométrie thoracique a identifié le cathéter migré rétroflexé sur lui-même dans la veine cave crânienne et s’étendant dans l’artère pulmonaire droite lorsqu’il traversait le côté droit du coeur. Le chien a subi une approche chirurgicale hybride consistant en une technique de forceps de récupération endovasculaire avec sternotomie médiane pour l’extraction intraveineuse de corps étrangers nonradio-opaques. Les complications postopératoires, y compris la régurgitation et le thrombus auriculaire gauche, ont été prises en charge. Le thrombus auriculaire gauche a persisté pendant 10 mois après la chirurgie hybride.Message clinique clé :Une approche hybride consistant en une technique de forceps de récupération endovasculaire avec sternotomie médiane a été efficace pour retirer un corps étranger intraveineux non-radio-opaque chez un chien.(Traduit par Dr Serge Messier).

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Figures

Figure 1
Figure 1
Computed tomography (CT) imaging. A — Thoracic CT soft tissue window dorsal reconstruction showing a part of the catheter (arrow) retroflexed within the cranial vena cava, before the bifurcation into the left and right brachiocephalic veins (asterisks). B — Thoracic CT soft tissue axial image showing a part of the catheter (arrow) within the right pulmonary artery. Parts of the catheter are also visible within the cranial vena cava (circle) and the right ventricle (square).
Figure 2
Figure 2
Echocardiography imaging. Five days after surgery, an oblique right parasternal long-axis 4-chamber view of the heart showing a left atrial thrombus on the posterior wall, measuring 13 × 16 mm.
Figure 3
Figure 3
Echocardiography imaging. Ten months after surgery, a right parasternal long-axis 4-chamber view of the heart showing a left atrial thrombus on the posterior wall, measuring 12 × 6.5 mm.
See this image and copyright information in PMC

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