Removal of Broken Umbilical Venous Catheter from Inferior Vena Cava Via Cardiac (Femoral) Catheterization: A Case Report in Neonatal Intensive Care Unit (NICU) of Mataria Teaching Hospital

Background: Arterial and venous umbilical catheters are used for drugs, fluids, and blood products administration and for exchange transfusion, in delivery room for neonatal resuscitation, and also for admitted critically ill neonates. Neonatologist can insert both umbilical catheters easily in short time. In spite of this, many unavoidable complications can occur as pericardial effusion, sepsis, thrombosis, and arrhythmia. Umbilical catheter breakage is a rare complication but it can happen during insertion or removal of the catheter. Various procedures are used for retrieval of the broken catheter. Surgical, vascular, and pediatric cardiac expert in catheterization should be consulted to choose the safest method for removal of the fractured catheter and to be stand by in case of failure of the chosen technique during the intervention.
Case Report: A 20 days old near term infant with a birth weight of 2400 g was born by cesarean section. He was admitted to NICU of Mataria Teaching Hospital because of respiratory distress due to congenital pneumonia.
Results: A reported case of a near term male at neonatal intensive care unit (NICU), Mataria Teaching Hospital was diagnosed by X-ray, on the second day of the removal of umbilical venous catheter (UVC), to have a fractured UVC at junction of hepatic vein and right atrium. Patient was transferred to Ain Shams University Children Hospital Cath Lab for trial of percutaneous removal of the remaining catheter segment, where it was retrieved successfully.
Conclusion: Fracture and embolization of a UVC is a rare but serious complication. Percutaneous retrieval of broken catheters using minibasket microsnare is amenable and safe procedure in neonates that can be done with minimal patient risk.