Dislodgment of Port-A-Cath Catheters in Children

BackgroundPort-a-cath catheters are frequently used in children with malignancies. Their dislodgment is rare, but carries potentially serious risks. This study analyzed our 11-year experience of this important issue.MethodsBetween June 1997 and January 2008, 290 ports of different brands were implanted in children by pediatric surgeons. Among the patients, 12 children with catheter dislodgement were retrospectively studied. Their ages ranged from 2-16 years, with a median of 6.4 years. Their body weights ranged from 12-39 kg, with a medi an of 20 kg. Ten patients presented with a port-a-cath dysfunction, while the other two patients were identified incidentally during surgery for removal of their ports.ResultsThe downstream ends of dislodged catheters were located in the right ventricle (five patients), right atrium (four), main pulmonary artery (one), left pulmonary artery (one) and right pulmonary artery (one). Eleven catheters were broken, and one catheter was disconnected from the port. Most (10/11) catheters were broken at the site of anastomosis to the port. All dislodged catheters were successfully retrieved without complications by transcatheter retrieval using a gooseneck snare.ConclusionThe dislodgment rate of port-a-cath catheters in children in our series was 4.1%. Most (83%) catheters were broken at the site of anastomosis to the port. All dislodged catheters could be successfully retrieved by transcatheter retrieval using a gooseneck snare.