Implantierbare Kathetersysteme: Erfahrungen bei 205 Patienten

Laffer, U; Dürig, Michael; Bloch, Hubert; Zuber, Mohammed; Stoll, H. R.

doi:10.1055/s-2008-1066650

Cited by 19 publications

(1 citation statement)

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“…Neben der Entwicklung vonH autnekrosen und Thrombosen stellt die bakterielle Besiedlung dasHauptrisikovon Portkathetern dar. In großenStudienwird die Infektionsrate mit 0,21-0,66p ro 1000 Kathetertage angegeben (6,9,15,23,26,27). Damitliegt die Rate deutlichniedrigerals fürKatheter, die die Haut penetrieren(2,4-2,77/1000 d) (9,22).…”

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Lebensbedrohliche Kardiomyopathie als Folge einer Portkatheterinfektion bei Immuntoleranztherapie

Wiegand¹,

Rauch²,

Girisch³

et al. 2007

Hamostaseologie

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The development of inhibitors in patients with severe haemophilia A is a serious complication requiring long term immune tolerance therapy (ITT). ITT frequently requires implantable central venous access, mostly port catheters. Their use may be complicated by thrombosis and infection. We report on an 18 year old patient with severe haemophilia A who had developed a high-titre factor VIII inhibitor in the age of five years. ITT required the implantation of a port system. The postoperative course was complicated by severe septicaemia with congestive cardiac failure. The port catheter was removed due to recurrent fever after 26 days. Our patient developed dilative cardiomyopathy. ITT had to be stopped and was replaced by on demand therapy with an activated prothrombin complex concentrate. Cardiomyopathy resulted in congestive heart failure, severe ventricular arrhythmias and the death of the young man. In patients with haemophilia, dilative cardiomyopathy and development of inhibitors the possibility of cardiac transplantation should be evaluated before increasing inhibitors and the development of pulmonary hypertension exclude this therapeutical option.

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