Bortone A, Corne P, Macia J C, Landreau L, Moulaire V, Leclercq F, Jonquet O
Service de cardiologie A, hôpital Arnaud de Villeneuve, Montpellier.
Arch Mal Coeur Vaiss. 2004 Jun;97(6):693-6.
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.
我们描述了一名39岁接受锁骨下静脉插管的女性在三天内右心房侧壁出现一个带蒂肿物的情况。她目前吸烟且酗酒，但无药物成瘾史。起初考虑为非瓣膜性右心房感染性心内膜炎，但随后的情况使诊断指向血栓，该血栓经肝素治疗后吸收。我们讨论了中心静脉导管所致血栓的发生率、并发症、治疗及鉴别诊断。中心静脉导管所致右心房血栓的预防取决于中心静脉导管尖端的位置，即在上腔静脉内还是在上腔静脉与右心房交界处。更靠远端的位置是血栓形成和栓塞并发症的常见来源。
