Malposition of Central Venous Pressure Catheter as a Rare Cause of Tricuspid Valve Prosthesis Malfunction: A Case Report

Mohaddeseh Behjati; Fatemeh Tohidi; Bahador Baharestani

doi:10.18502/acta.v61i12.16375

Mohaddeseh Behjati Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Fatemeh Tohidi Department of Medical Biotechnology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
Bahador Baharestani Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v61i12.16375

Keywords: Tricuspid valve; Prosthetic malfunction; Central venous pressure catheter

Abstract

Prosthetic valve malfunction is a hazardous clinical entity that needs early diagnosis and management. Hereby, we present a case of tricuspid valve (TV) malfunction due to interaction of central venous pressure (CVP) catheter with TV leaflets. Our case was a 38-year-old male who referred to our center with the diagnosis of TV malfunction. Confirming the diagnosis of TV malfunction, intravenous Heparin was initiated. Anticoagulation therapy was discontinued early due to the development of significant headache in the setting of subarachnoid hemorrhage. Due to contraindication of anticoagulation therapy, he underwent redo TV. On the 4^th post-operative day, echocardiography examination illustrated significant increase in gradients of TV prosthesis. At this time, fluoroscopy depicted interaction of CVP catheter with TV leaflets due to its cardiac advancement resulted in fixed TV leaflets in semi-open position. By extraction of CVP catheter the TV gradients improved immediately. Malposition of CVP catheter or large CVP catheter could be considered as one of the rare causes of TV malfunction. Repositioning of CVP catheter brings dramatic improvement in this case.