Direct right atrial catheter insertion with video-assisted thoracic surgery

Intracardiac access for hemodialysis: A case series

“…18 Care of the catheter after placement must also be considered, as accidental removal may require repeat thoracotomy for replacement, although replacement over a wire via the fistula tract was performed multiple times in our patient. Some experts believe that it may be entirely viable to place the catheter using minimally invasive techniques such as video-assisted thoracic surgery.…”

Thoracoscopic-assisted central line placement for a thrombosed superior vena cava

“…In children and adults with occluded vessels, various techniques such as transhepatic cannulation, thoracotomy for azygos catheter insertion, and direct atrial catheter insertion have been described in the literature [2][3][4][5][6]. However, these techniques have limitations, and some of them are major procedures with substantial risks and limiting the possibilities of using the same route if required at another occasion.…”

“…Because the number of access sites is limited, children who need long-term venous access rapidly become a surgical challenge [1]. In such children, different techniques to establish venous access have been described in the literature; most of them will require major operation [2][3][4][5][6]. We report an innovative technique of catheter insertion percutaneously from the neck into the right atrium traversing a thrombosed superior vena cava (SVC) using video-assisted thoracoscopic surgery (VATS).…”

Alternate Access for Catheter Hemodialysis

“…Recent developments now allow placement into these vessels using minimally invasive surgery by thoracoscopy (83). Today, these surgical methods are considered techniques of last resort.…”

“…The established surgical options to gain venous access in the setting of occlusion of the traditional chest and neck sites include direct catheter placement into the right atrium (79), azygos vein (80)(81)(82), or superior vena cava (82). Recent developments now allow placement into these vessels using minimally invasive surgery by thoracoscopy (83). Today, these surgical methods are considered techniques of last resort.…”