Mori T, Arisawa M, Fukuoka M, Tamura K, Kurisaka M, Mori K
Department of Neurosurgery, Kochi Medical School.
Neurol Med Chir (Tokyo). 1993 Oct;33(10):713-5. doi: 10.2176/nmc.33.713.
A 21-year-old male, who had undergone a ventriculoatrial shunt for hydrocephalus 5 years previously, became stuporous. A roentgenogram revealed that the distal segment of the broken atrial catheter had migrated and become lodged in the heart. Because the fragment had not adhered to the myocardium, it was easily retrieved by the transvenous approach with a retriever catheter. If the migrated catheter does not adhere to the myocardium, transvenous catheter retrieval is absolutely necessary. If, however, the migrated catheter adheres to the myocardium, an open thoracotomy would be required for retrieval, or the alternative of warfarin administration without retrieval may be the treatment of choice, as long as other problems do not occur.
一名21岁男性,5年前因脑积水接受了脑室-心房分流术,现陷入昏迷。X线片显示,断裂的心房导管远端移位并卡在心脏中。由于碎片未附着于心肌,通过静脉途径使用回收导管很容易将其取出。如果移位的导管未附着于心肌,经静脉导管取出是绝对必要的。然而,如果移位的导管附着于心肌,则需要开胸取出,或者在不取出的情况下选择使用华法林治疗,只要不出现其他问题。