Polyethylene Catheter Embolism

A 62-year-old man died from tricuspid monilial endocarditis and systemic candidiasis associated with embolization to the right heart of a 36-cm fragment of one polyethylene catheter received in the venous system approximately one year earlier. Thirty-six additional cases of catheter embolism are reviewed and tabulated. In 17 of the 37 patients the catheter fragment had reached the right side of the heart, and in eight, a branch of the pulmonary artery. In six of 13 patients who died, catheter embolism was the exclusive or a major contributory cause of death. Measures designed to prevent the breakage and embolization of polyethylene tubes and to facilitate their retrieval in case of loss are discussed. If a catheter fragment has been lost into the venous system, it should be located and removed at once. Monilial endocarditis and systemic candidiasis are briefly reviewed. The reported case is the first in which these entities have been associated with catheter embolism to the heart, and the fourth in which monilial endocarditis affected the tricuspid valve.