"Fishing for lines": removal of endovascular catheters from the cardiovascular system

Wong AR, Suhaimi H, Ridzuan MAR, Rizal MMZ, Saedah A 
Correspondence: Dr Abdul Rahim Wong, rahim@kck.usm.my

ABSTRACT
We present two infants whose endovascular lines were accidentally cut or fractured, and had to be retrieved via transcatheter means in the cardiac catheterisation laboratory. The first case was a two-month-old infant with transposition of the great arteries, requiring an emergency balloon atrial septostomy. An indwelling vascular catheter that was placed in the right femoral vein was accidentally cut and had migrated into the inferior vena cava, before being retrieved. The second case was a one-week-old neonate who presented with pneumonia at birth, and had a long intravenous catheter placed in the left saphenous vein, which became fractured, and subsequently migrated into the heart. This case presented as a pulmonary embolus with haemodynamic instability, as the catheter had partially obstructed the right ventricular outflow tract. This was later retrieved via transcatheter means.

Keywords: endovascular catheter complications, endovascular catheter removal, indwelling venous catheters, snare, transcatheter retrieval
Singapore Med J 2009; 50(10): e358-e361