Cardiac Migration of Chemoport Catheter-A Rare Complication: Review of Literature and Our Experience

Chemoport devices are commonly used for the administration of chemotherapeutic medication in cancer patients and can also be used for total parenteral nutrition and long term intravenous therapy. They are usually inserted through the internal jugular vein or the subclavian vein. The common complications of the procedure include pneumothorax, bleeding, arrhythmia and venous thrombosis. One of the rare complications of chemoport is catheter fracture/dislodgement and subsequent migration, with an incidence of 0.1-2.1%. Other rare complications are vascular erosion and embolization, vocal cord palsy and mediastinal hematoma. The aims and objectives are as follows: (1) to report a rare case of chemoport catheter migration between the right ventricle and pulmonary artery and (2) to review the literature on the rare complication of cardiac migration of a chemoport. A 56-year-old lady, known case of carcinoma right breast, post modified radical mastectomy was advised adjuvant chemotherapy. A chemoport catheter was placed in the right internal jugular vein and was positioned over the left upper chest. The 1st cycle of chemotherapy was given through chemoport and was uneventful. On the second chemotherapy schedule, catheter dysfunction was found. For the same, she was evaluated with chest radiography, which showed the migrated catheter in the heart. The migrated catheter was retrieved by snare technique using percutaneous transvenous route. The procedure was uneventful. The literature on the topic was reviewed. Chemoport catheter fracture or dislodgement and its subsequent cardiac migration are a rare but serious complication. High index of suspicion in case of catheter dysfunction, early detection by chest radiography, and timely multi-disciplinary intervention is crucial.