Transvenous retrieval is a safe and effective method for removing a migrated atrial catheter from a ventriculoatrial shunt if it has not adhered to the myocardium.
Supports feasibility of percutaneous retrieval for migrated atrial catheters; leaves open need for larger studies to confirm safety.
A 21-year-old male, who had undergone a ventriculoatrial shunt for hydrocephalus 5 years previously, became stuporous. A roentgenogram revealed that the distal segment of the broken atrial catheter had migrated and become lodged in the heart. Because the fragment had not adhered to the myocardium, it was easily retrieved by the transvenous approach with a retriever catheter. If the migrated catheter does not adhere to the myocardium, transvenous catheter retrieval is absolutely necessary. If, however, the migrated catheter adheres to the myocardium, an open thoracotomy would be required for retrieval, or the alternative of warfarin administration without retrieval may be the treatment of choice, as long as other problems do not occur.
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Mori et al. (1993) studied this question.
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