Chronic thromboembolic pulmonary hypertension following long-term peripherally inserted central venous catheter use

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Title: Chronic thromboembolic pulmonary hypertension following long-term peripherally inserted central venous catheter use
Authors: Masding, A
Preston, SD
Toshner, M
Barnett, J
Harries, C
Dimopoulos, K
Kempny, A
McCabe, C
Jenkins, DP
Wort, SJ
Price, LC
Item Type: Journal Article
Abstract: A 36-year-old woman presented with recurrent pulmonary emboli (PE) despite oral anticoagulation. She was a type I diabetic with severe gastroparesis requiring insertion of multiple long-term peripherally inserted central catheters (PICC) over a 10-year period. Imaging at presentation demonstrated a PICC-associated mobile mass in the right atrium and signs of pulmonary hypertension (PH). She was thrombolyzed and fully anticoagulated, and diabetic management without PICC strongly recommended. PH persisted, however, and she developed chronic thromboembolic pulmonary hypertension (CTEPH), for which successful pulmonary endarterectomy (PEA) surgery led to symptomatic and hemodynamic improvement. This was the first case of CTEPH reported related to long-term PICC use outside the setting of malignant disease, and a novel observation that the PEA specimen contained multiple plastic fragments. Long-term PICC placement increases the risk of CTEPH, a life-threatening, albeit treatable, complication.
Issue Date: 27-Jun-2019
Date of Acceptance: 24-Mar-2019
URI: http://hdl.handle.net/10044/1/71863
DOI: https://doi.org/10.1177/2045894019859474
ISSN: 2045-8940
Publisher: SAGE
Journal / Book Title: Pulmonary Circulation
Volume: 9
Issue: 2
Copyright Statement: © 2019 The Authors. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Respiratory System
Cardiovascular System & Cardiology
Chronic thromboembolic pulmonary hypertension
diabetes
pulmonary endarterectomy
RISK
Chronic thromboembolic pulmonary hypertension
diabetes
pulmonary endarterectomy
Chronic thromboembolic pulmonary hypertension
diabetes
pulmonary endarterectomy
Publication Status: Published
Conference Place: United States
Online Publication Date: 2019-06-27
Appears in Collections:National Heart and Lung Institute



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