Transesophageal echocardiography-guided repositioning of a totally implantable venous access device that migrated into the left atrium across a patent foramen ovale

Migration of a totally implantable venous access port into the cardiac chambers can lead to a wide range of potentially serious complications. Malpositioned devices require thorough clinical assessment and timely intervention to minimize associated risks. We report the case of a patient whose catheter tip migrated across a patent foramen ovale into the left atrium. Because prompt surgical repositioning was required, conscious sedation and real-time transesophageal echocardiography were utilized to provide precise guidance. This approach enabled safe catheter withdrawal, accurate repositioning within the superior vena cava, and immediate confirmation of catheter function using a saline flush test.