Right intra-atrial haemodialysis catheter insertion via sternotomy with intrathoracic graft placement: A case report.
Andreia Carnevale, Maria Inês Roxo, Tiago J Carvalho et al.
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Case in brief
A patient with haemodialysis access exhaustion had several anomalies of central venous drainage and multiple failed arteriovenous accesses. An unconventional approach was used: a haemodialysis catheter was placed in the right atrium via sternotomy, with an intrathoracic graft. The catheter was successfully used for over 18 months.
What made this case unusual
The access route combined sternotomy, right intra-atrial catheter placement and an intrathoracic graft after conventional vascular access options had failed.
Diagnostic / clinical pearl
In a patient with exhausted vascular access and anomalous central venous drainage, trans-atrial catheter placement via sternotomy with an intrathoracic graft may be a viable option when other methods have failed.