Recurrent catheter-related right atrial thrombosis in a hemodialysis patient: A case report and literature review

Figures

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  Fig. 1. Computed tomography (CT) demonstrating a subdural hematoma involving the right frontotemporal-parietal area.

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  Fig. 2. Transthoracic echocardiography (TTE) revealing a mixed-echo mass (asterisk) located opposite the tip of the dialysis catheter (arrow), attached to the right atrium near the opening of the inferior vena cava. LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.

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  Fig. 3. Chest X-ray showing the catheter tip positioned within the right atrium.

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  Fig. 4. (A) Visualization of the catheter tip during right atrial thrombectomy (white arrow). (B) Intraoperative finding of a 3 × 4 cm mass infiltrating the atrial wall near the right atrium.

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  Fig. 5. Histopathological examination confirming the thrombus, consists of layered fibrin strands (pink amorphous material) interspersed with aggregated red blood cells (RBCs, anucleate eosinophilic discs) and scattered inflammatory cells (lymphocytes and neutrophils with segmented nuclei) Hematoxylin–eosin stain, ×200 magnification.

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  Fig. 6. Postcardiac surgery transesophageal echocardiography demonstrating complete resolution of the right atrial mass at the previous site of the mass (asterisk). LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.

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  Fig. 7. Transesophageal echocardiography performed 7 days postoperatively revealing a new 30.7 × 16.5 mm mixed-echo mass (asterisk). LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.

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  Fig. 8. One week postoperatively, transthoracic echocardiography in the apical 4-chamber view demonstrating persistence of the right atrial thrombus (asterisk). LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.