Çimen Tolga, Doğan Mehmet, Akyel Ahmet, Yeter Ekrem
Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey.
Postepy Kardiol Interwencyjnej. 2015;11(1):62-3. doi: 10.5114/pwki.2015.49189. Epub 2015 Mar 6.
Treatment of a central venous catheter emboli that has been asymptomatic for a number of years is controversial. A 56-year-old male patient who had an operation for sinus Valsalva aneurism rupture 22 years ago was referred to cardiology department for routine control. He had a mass inside the right heart on echocardiographic examination, and computed tomography revealed that this mass was an embolic piece of catheter. Catheters that have stayed inside the heart for a long time are removed due to the risk of distal embolisation and endocarditis, but the risk of removal is not known. Non-invasive follow-up of asymptomatic patients is often preferred because of the stabilisation of the embolised catheter due to endothelisation and the risk of complications during removal. Treatment of patients with catheter-piece emboli who are asymptomatic should be individualised, taking into account the risk of thrombosis, arrhythmia, and infection.
对于多年来一直无症状的中心静脉导管栓子的治疗存在争议。一名56岁男性患者，22年前因瓦尔萨尔瓦窦瘤破裂接受手术，现转诊至心内科进行常规检查。超声心动图检查发现其右心内有一肿块，计算机断层扫描显示该肿块为导管栓子碎片。由于存在远端栓塞和心内膜炎的风险，长期留存于心脏内的导管通常会被取出，但取出的风险尚不清楚。由于栓塞导管会因内皮化而稳定，且取出过程中有并发症风险，对于无症状患者，通常更倾向于进行非侵入性随访。对于无症状的导管碎片栓子患者，应根据血栓形成、心律失常和感染的风险进行个体化治疗。
