Skip to main content

Advertisement

Log in

Long term central venous catheters for haemodialysis causing an extra-cardiac right-to-left shunt

  • Case Report
  • Published:
Journal of Nephrology Aims and scope Submit manuscript

A Correction to this article was published on 18 May 2022

This article has been updated

Abstract

Central venous catheters can provide long-term access for haemodialysis patients who cannot have an arteriovenous fistula or graft fashioned. However, long-term central venous catheter use for haemodialysis may lead to complications including central venous stenosis, and superior vena cava obstruction in its worst form. Here, we describe the case of a patient on haemodialysis via central venous catheters for over 20 years, in whom chronic superior vena cava obstruction led to the development of mediastinal collateral vessels. These drained deoxygenated systemic venous blood into the oxygenated pulmonary venous system. Over time, this caused a significant right-to-left shunt and resulting hypoxaemia. This is the first reported case of central venous catheters used for haemodialysis resulting in an acquired, extra-cardiac, right-to-left shunt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Change history

References

  1. Adwaney A et al (2019) Central venous stenosis, access outcome and survival in patients undergoing maintenance hemodialysis. Clin J Am Soc Nephrol 14(3):378–384

    Article  Google Scholar 

  2. Roper T et al (2020) Collateral damage-the risks of central venous hemodialysis catheters. Kidney Int Rep 5(5):746–750

    Article  Google Scholar 

  3. Siegel Y, Kuker R (2016) Superior vena cava obstruction in hemodialysis patients: symptoms, clinical presentation and outcomes compared to other etiologies. Ther Apher Dial 20(4):390–393

    Article  Google Scholar 

  4. Kapur S et al (2010) Where there is blood, there is a way: unusual collateral vessels in superior and inferior vena cava obstruction. Radiographics 30(1):67–78

    Article  Google Scholar 

  5. Marini TJ et al (2019) Blood finds a way: pictorial review of thoracic collateral vessels. Insights Imaging 10(1):63

    Article  Google Scholar 

  6. Khosa J, Lee S (2020) The path of least resistance: chronic indwelling catheter complications of fibrin sheath formation in a patient with pericardial collateralization. Chest 158(4 Supplement):A1990

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Charlotte Seneschall.

Ethics declarations

Conflict of interest

There are no conflicts of interest.

Ethical disclosures

Nothing to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original article has been updated: Due to co-author name update.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seneschall, C., Ferguson, C., Gopalan, D. et al. Long term central venous catheters for haemodialysis causing an extra-cardiac right-to-left shunt. J Nephrol 35, 1521–1524 (2022). https://doi.org/10.1007/s40620-022-01342-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40620-022-01342-9

Keywords

Navigation