Han Zonghong, He Zhongming, Chen Wenhua, Wang Qi
Department of Interventional Radiology, First People's Hospital of Changzhou, Changzhou, China.
Front Cardiovasc Med. 2025 Aug 18;12:1581930. doi: 10.3389/fcvm.2025.1581930. eCollection 2025.
Totally implantable venous access ports (TIVAPs) are commonly used for patients undergoing chemotherapy and long-term repeated infusions. The incidence of thrombosis is low and rarely leads to serious complications. We report a case of right atrial thrombosis and paradoxical embolism in a 58-year-old male with atrial fibrillation (AF) and patent foramen ovale (PFO) 28 months after TIVAP implantation. The patient presented with dizziness and left limb weakness, subsequent diagnostic imaging revealed right temporal lobe infarction and a mass in the right atrium, who eventually recovered and was discharged after cardiac surgery and anticoagulation. This case highlights the rare but severe complication of right atrial thrombosis associated with TIVAP, particularly in patients with AF and PFO. Proper placement and timely removal of totally implantable venous access ports are crucial to minimize complications. Further research is needed to determine the necessity of anti-coagulation and PFO screening in patients with AF receiving central venous catheters.
全植入式静脉通路端口（TIVAPs）常用于接受化疗和长期反复输液的患者。血栓形成的发生率较低，很少导致严重并发症。我们报告一例58岁男性患者，在植入TIVAP 28个月后发生右心房血栓形成和反常栓塞，该患者患有心房颤动（AF）和卵圆孔未闭（PFO）。患者出现头晕和左下肢无力，随后的诊断性影像学检查显示右颞叶梗死和右心房肿块，最终在心脏手术后和抗凝治疗后康复出院。该病例突出了与TIVAP相关的右心房血栓形成这一罕见但严重的并发症，尤其是在患有AF和PFO的患者中。正确放置和及时移除全植入式静脉通路端口对于将并发症降至最低至关重要。需要进一步研究以确定接受中心静脉导管置入的AF患者进行抗凝和PFO筛查的必要性。
