Case report: Central venous catheter thrombosis complicated by chronic thromboembolic disease/pulmonary hypertension in two children requiring parenteral nutrition.

病例报告 ： 两个需要肠胃外营养的儿童中 ， 中心静脉导管血栓并发慢性血栓栓塞性疾病 / 肺动脉高压。

• 影响指数: 5.846
• 发表时间: 2023
• 来源期刊: Front Cardiovasc Med
• DOI: 10.3389/fcvm.2023.1198204
• PMID: 37363098
• 文章类型: Case Reports
• 作者列表: Hanuna M,Pattathu J,Buech J,Kamla C,Kneidinger N,Behr J,Milger K,Veit T,Nagel M,Abicht J,Dalla-Pozza R,Fischer M,Jakob A,Hermann M,Schramm R,Rosenthal LL,Haas N,Hörer J,Hagl C,Michel SG

关键词: chronic thromboembolic pulmonary hypertension; hickmann-catheter; parenteral nutrition (PN); pulmonary embolism; pulmonary endarterectomy

Abstract

Chronic thromboembolic pulmonary hypertension is a rare but life-threatening complication of long-term central venous catheters (CVC) in children. However, evidence in terms of potential treatment strategies and outcome data remains scarce. We describe two cases of CVC-related thrombosis (Hickman-catheter) complicated by recurrent pulmonary emboli. One patient experienced a complete thromboembolic obstruction of the right pulmonary artery with normal pulmonary pressures and the second patient suffered from a central thromboembolic obstruction of both pulmonary arteries associated with severe pulmonary hypertension. Both patients successfully underwent surgical thromboendarterectomy with deep hypothermic circulatory arrest.

摘要

慢性血栓栓塞性肺动脉高压是儿童长期中心静脉导管（CVC）的罕见但危及生命的并发症。然而,潜在治疗策略和结局数据方面的证据仍然很少.我们描述了两例CVC相关血栓形成（希克曼导管）并发复发性肺栓塞的病例。一名患者在正常的肺动脉压力下经历了右肺动脉的完全血栓栓塞性阻塞，另一名患者患有与严重肺动脉高压相关的两个肺动脉的中央血栓栓塞性阻塞。两名患者均成功接受了深低温停循环的血栓内膜切除术。