Catheter Entrapment Research Articles

Ablation Catheter Entrapment by Chordae Tendineae in the Mitral Valve During Ventricular Tachycardia Ablation

We report on the entrapment of an ablation catheter by chordae tendineae in the mitral valve during radiofrequency (RF) ablation of ventricular tachycardia. The entrapped tip had to be removed via open surgery. Great care must be taken when performing radiofrequency ablation around the mitral valve apparatus.

Successful surgical treatment of intravascular ultrasonography catheter entrapment

Coronary angiography (CAG) was performed in a 77-year-old woman who presented with chest discomfort. The CAG showed two diseased vessels. For treatment, the patient underwent angioplasty and stenting. During intravascular ultrasonography (IVUS) following stent deployment, the IVUS catheter became entrapped in the left anterior descending coronary artery, causing ischemic changes in the anterolateral wall, which were apparent on the electrocardiogram. The patient underwent emergency coronary artery bypass grafting and removal of the entrapped IVUS catheter.

Radiofrequency Ablation of Atrial Fibrillation in Patients With Mechanical Mitral Valve Prostheses: Safety, Feasibility, Electrophysiologic Findings, and Outcomes

The purpose of this study was to evaluate the feasibility, safety, and outcomes of radiofrequency ablation of atrial fibrillation (AF) in patients with mechanical mitral valve replacement (MVR). The role of ablative therapy in patients with MVR is not yet established, with safety concerns and very few outcome data. Between January 2003 and December 2008, we followed up 81 patients with MVR undergoing first-time AF ablation (compared with 162 age- and sex-matched controls). Arrhythmia recurrences were identified by symptoms with documentation, event monitoring, Holter monitoring, and electrocardiograms. All MVR and control patients underwent ablation under therapeutic international normalized ratio. No entrapment of catheters or stroke occurred. There were no differences in terms of procedure-related complications between the groups (p = NS). Patients with MVR had larger atria (p < 0.0001), lower left ventricular ejection fractions (p = 0.0001), and more concomitant atrial flutter at baseline (p < 0.0001). Over a 24-month follow-up, they had higher recurrence rates compared with controls (49.4% vs. 27.7% after a single ablation, p = 0.0006). The creation of flutter lines significantly reduced recurrences in patients with any history of atrial flutter (16.7% vs. 60.9%, p = 0.009). At last follow-up, 82.7% of MVR patients had their arrhythmia controlled (69.1% not receiving antiarrhythmic drugs). Radiofrequency ablation is feasible and safe for patients with MVR. It allowed restoration of sinus rhythm in a substantial proportion of patients undergoing ablation. An abnormal atrial substrate underlies recurrences in these patients. The ablation procedure needs to be further refined with a focus on extra pulmonary vein triggers and concomitant flutters to improve outcomes.

Brachial Plexus Entrapment of Interscalene Nerve Catheter after Uncomplicated Ultrasound-Guided Placement

We report on the case of an entrapped interscalene nerve catheter in a 46-year-old male undergoing left shoulder arthroscopic lysis of adhesions for a frozen shoulder. The catheter was placed under ultrasound guidance without any apparent complications. The continuous interscalene nerve block was successfully used as the primary anesthetic and for postoperative pain management. Upon attempted catheter removal, the patient experienced severe pain and paresthesias. Fluoroscopy revealed possible brachial plexus involvement, and surgery was performed to extract the catheter, which had become hooked and entrapped around the C5 nerve root and sheath.

SHA 033. Pulmonary artery catheter entrapment in cardiac surgery

A pulmonary artery catheter (PAC) is an important tool in the preoperative cardiac management, and it provides measurements which helps in the patient management. During open heart surgery the catheter tends to rest against the anterior lateral wall of the right atrium where the catheter may be caught by a suture in the cannulation for cardiopulmonary bypass. We describe a very rare complication which is inadvertent surgical suturing of the PAC to the inferior vena cava that necessitated reopening the chest, cutting, the suture and removing the catheter. Chest X-ray can be helpful in the diagnosis of PAC entrapment due to suture fixation. Angulation of the catheter is an important diagnostic sign.

Noncardiac entrapment of a pulmonary artery catheter during heart transplantation: inadvertent cannulation and perforation of the internal thoracic vein

Placement of a central venous catheter into an internal thoracic vein occurs in approximately 2% of all catheterizations. A case in which a pulmonary artery catheter was trapped within the internal thoracic vein during orthotopic heart transplantation is presented.

Surgical Removal of a Ruptured, Detached Angioplasty Balloon after Popliteal Stenting

Balloon catheter entrapment after stent implantation is a potential interventional complication. However, angioplasty balloon disconnection from the catheter shaft and in-stent entrapment is a very uncommon event that could have serious thrombotic or embolic consequences. The management of this event may be interventional or surgical, depending on the patient's status and the position of the balloon inside the vessel. We describe a case of acute lower limb ischemia after popliteal self-expandable stenting, due to loss of the balloon along with a portion of its shaft. Surgical retrieval was accomplished without any further complications.

Catheter entrapment around the Chiari Network during percutaneous atrial septal defect closure

Catheter entrapment around the Chiari Network during percutaneous atrial septal defect closure

Inadvertent Entrapment of a Central Venous Catheter by a Purse-String Suture during Cardiopulmonary Bypass: A Case Report

A 65-year-old female patient with severe mitral valve stenosis plus coronary artery disease was scheduled for mitral valve replacement and 2-vessel coronary artery bypass graft (CABG) surgeries simultaneously. After a successful procedure, resistance was met on a CVC withdrawal. During postoperative fluoroscopy, fixation of the catheter at the heart was confirmed which necessitated reopening the chest, cutting the suture, and removing the catheter. When a catheter became hard to withdraw after open heart surgery, we should never withdraw it forcefully and blindly. Although rare, one should consider inadvertent entrapment of CVC by a suture as the possible cause.

Recanalization of an Accidentally Crushed Coronary Stent by Intravascular Ultrasonography Catheter Entrapment

Intravascular ultrasonography (IVUS) imaging is a user-friendly technique widely used during coronary interventions. An 80-year-old man was admitted with chest pain, and successful percutaneous coronary intervention was performed with stent implantation. One week later, the patient complained of further chest pain. Urgent coronary angiography showed total occlusion of the middle left anterior descending artery and the aspiration of thrombi was high. IVUS imaging showed inadequate stent strut apposition and distal dissection. We attempted another stent implantation but the IVUS catheter was stuck on the 0.014 inch wire. Therefore, we tried to pass the wire across the lateral side. After the wire was successfully passaged, the sprinter balloon was passed through the crushed stent to expand it. After 4 days later, the patient was discharged with no symptoms or electrocardiographic change.

William Tell's arrow and the entrapment of catheters by a vascular closure device

William Tell's arrow and the entrapment of catheters by a vascular closure device

Entrapment of an arterial pressure catheter by a previously deployed starclose device

Herein is a case report description of entrapment of an arterial pressure line by a previously deployed Starclose device. This device is widely used to control femoral artery puncture site following diagnostic catheterization.

Entrapment of the circular mapping catheter in the mitral valve in two patients undergoing atrial fibrillation ablation

The circular catheter is a useful tool to guide and test pulmonary vein (PV) isolation in atrial fibrillation ablation. However, its shape may facilitate entrapment in cardiac structures. We describe the entrapment of a circular mapping catheter within the mitral valve apparatus after transseptal catheterization and mapping of the left atrium and PVs in two of our patients.

Device Malfunction of the CardioWest Total Artificial Heart Secondary to Catheter Entrapment of the Tricuspid Valve

We report two cases at a single institution, a 52-year-old man and a 25-year-old woman, who had failures of their CardioWest total artificial hearts (TAH) from central venous lines that caused obstruction of the right ventricular inflow valves. Each patient was noted to have decreasing TAH outputs for a few days before this catastrophic device arrest. Both patients died; one suddenly and one during a protracted period, as a result of catheter entrapment of the disc of the Medtronic Hall right ventricular inflow valve.

Catheter Entrapment in a Pulmonary Vein: A Unique Complication of Pulmonary Vein Isolation

Ablation strategies for the treatment of atrial fibrillation (AF) are associated with several potential complications. During electro-anatomic mapping of the left atrium (LA) before ablation, the ablation catheter was entrapped in the right inferior pulmonary vein (RIPV). After multiple unsuccessful gentle tractions, stronger maneuvers with rotation of the catheter slowly allowed its retrieval. Examination of the catheter showed a thin, translucent membrane covering its tip, suggesting complete stripping of a vein branch. Occlusion of the superior branch of the RIPV was confirmed by LA angiogram. During the following days, no pericardial effusion was noted, but the patient complained of light chest pain and mild hemoptysis, spontaneously resolving within 48 h. This case shows that catheter entrapment and mechanical disruption of a PV branch can be a rare potential complication of AF ablation. In this case, the outcome was spontaneously favorable and symptoms only included transient mild hemoptysis.

Chiari’s network: review of the literature

The Chiari network, present in approximately 2% of the population, and is a reticulated network of fibers originating from the Eustachian connecting to different parts of the right atrium. Its presence results from incomplete reabsorption of the right valve of the sinus venosus. Chiari's network is often clinically insignificant. However, it has been reported to be involved in the pathogenesis of thromboembolic disease, endocarditis, arrhythmias, and entrapment of catheters upon percutaneous intervention. While initially discovered and researched using autopsy dissections, Chiari's network is often found as an incidental finding on diagnostic imaging studies, thus providing new methods for studying its incidence and clinical significance.

Peripheral nerve catheter entrapment is not always related to knotting

To the Editor,We recently experienced a case of difficult nerve cath-eter withdrawal, unrelated to knotting or malpositioning, ina young patient who had undergone major shoulder sur-gery. A 31-yr-old male who was scheduled for arthroscopicshoulder surgery received a right-sided stimulating inter-scalene catheter (Stimucath , Teleflex, Le Faget, France)for postoperative analgesia. Prior to induction of generalanesthesia, the catheter was inserted uneventfully usingnerve stimulator guidance. A C6 response was soughtthrough the stimulating catheter with a current thresh-old

Pulmonary artery catheter entrapment in cardiac surgery

A pulmonary artery catheter (PAC) is an important tool in the preoperative cardiac management, and it provides measurements which helps in the patient management During open heart surgery the catheter tends to rest against the anterior lateral wall of the right atrium where the catheter may be caught by a suture in the cannulation for cardiopulmonary bypass. We describe a very rare complication which is inadvertent surgical suturing of the PAC to the inferior vena cava that necessitated reopening the chest, cutting, the suture and removing the catheter.

Transesophageal Echocardiography Is Useful for an Intraoperative Diagnosis of Pulmonary Artery Catheter Entrapment

Transesophageal Echocardiography Is Useful for an Intraoperative Diagnosis of Pulmonary Artery Catheter Entrapment

Entrapment of a subclavian venous catheter in a child—How to get it out?

To report a rare case of an entrapped subclavian venous catheter and to describe an anatomically based maneuver to remove it. Case report. Pediatric critical care unit in a tertiary care hospital. An 8-yr-old girl suffering from 50% body surface area burns and clinical sepsis in whom a double lumen subclavian venous catheter, placed 12 days earlier, could not be removed. Concomitant abduction and internal rotation of the shoulder and outward traction in the scapular plane plus backward pressure on the first rib while carefully pulling out the entrapped catheter. Successful removal of the intact catheter, avoiding catheter disruption and embolization. Side hole of an acutely placed multilumen catheter may be entrapped at the costoclavicular angle. An anatomically-based maneuver may widen the gap between the clavicle and the first rib and enable safe removal of the catheter.