Annals of Clinical Cardiology

CASE REPORT
Year
: 2020  |  Volume : 2  |  Issue : 1  |  Page : 42--46

Perm-Cath catheter-related atrial thrombus – Case series and management recommendations


Prashanth Panduranga1, Kumail Al-Lawatiya1, Issa Al-Salmi2, Baher Hanna2 
1 Department of Cardiology, Royal Hospital, Muscat, Sultanate of Oman
2 Department of Nephrology, Royal Hospital, Muscat, Sultanate of Oman

Correspondence Address:
Dr. Prashanth Panduranga
Department of Cardiology, Royal Hospital, Post Box 1331, Muscat-111
Sultanate of Oman

Catheter-related atrial thrombus (CRAT) is frequent, with no clear guidelines available with regard to diagnosis and management. Here, we report five patients with Perm Cath related AT. We conclude and recommend that Perm Cath, when not needed or used needs to be removed as soon as possible. A majority of CRAT are detected incidentally. They commonly occur at inferior vena cava and right atrial junction and a transoesophageal echocardiogram is needed in most patients to clearly define the thrombus and see additional hidden thrombi. Differentiating CRAT versus vegetation is difficult and one needs to treat both if blood cultures are positive. Commonly these thrombi do not embolize and are fixed to atrial walls, but silent pulmonary embolism needs to be considered. All patients initially should be treated with intravenous or subcutaneous anticoagulation. Patients with “High Risk” features such as, “multiple thrombi > 2,” “mobile thrombi,” “extending or embolizing thrombi to pulmonary artery,” “infected thrombi,” and “failed anticoagulation” must be considered for thrombolysis followed by surgery if required.


How to cite this article:
Panduranga P, Al-Lawatiya K, Al-Salmi I, Hanna B. Perm-Cath catheter-related atrial thrombus – Case series and management recommendations.Ann Clin Cardiol 2020;2:42-46


How to cite this URL:
Panduranga P, Al-Lawatiya K, Al-Salmi I, Hanna B. Perm-Cath catheter-related atrial thrombus – Case series and management recommendations. Ann Clin Cardiol [serial online] 2020 [cited 2020 Oct 24 ];2:42-46
Available from: http://www.onlineacc.org/article.asp?issn=2666-6979;year=2020;volume=2;issue=1;spage=42;epage=46;aulast=Panduranga;type=0