Giant Right Atrial Thrombi Formation Associated with Hemodialysis Catheter Placement in a Dog

다국어 초록 (Multilingual Abstract)

A Cocker spaniel (7-year-old, female) was presented with one week of anorexia, halitosis, oral ulcer, intermittent vomiting, acute weight loss and 3-day history of oliguria. The patient was diagnosed with acute on chronic kidney disease and pancreatitis. Hemodialysis was continued three times a week (total 7 sessions) with improved clinical signs and kidney panel, but presented with another episode of abdominal distention, respiratory distress, and large bowel diarrhea. Echocardiography revealed nearly totally occlusive thrombus in the cranial vena cava, as well as a right atrial mass of approximately 2 cm × 1 cm. The patient was treated with catheter removal, thrombolysis and anticoagulation therapy with recombinant tissue plasminogen activator. During anticoagulation therapy, size of atrial thrombus was not changed and heart function was not improved after treatment. Since clinical signs were deteriorated, the patient was euthanized by owner’s request. Catheter-related giant thrombus in right atrium is a rare complication and treatment guideline for atrial thrombus does not exist. This case is first report of hemodialysis catheter-induced thrombus in Korea.

참고문헌 (Reference)

1 송영진, "혈전용해제 및 항응고제로 호전된 투석 도관 관련 우심방 거대 혈전 1예" 고신대학교 의과대학 학술지 28 (28): 61-65, 2013

2 Pittiruti M, "The electrocardiographic method for positioning the tip of central venous catheters" 12 : 280-291, 2011

3 Ali AB, "Right atrial thrombus post hemodialysis catheter : Case reports" 2 : 680-682, 2013

4 Ghani MK, "Right atrial thrombus formation associated with central venous catheters utilization in hemodialysis patients" 29 : 1829-1832, 2003

5 Ram R, "Right atrial thrombus due to internal jugular vein catheter" 13 : 261-265, 2009

6 Shah A, "Right atrial thrombi complicating use of central venous catheters in hemodialysis" 27 : 772-778, 2004

7 Stavroulopoulos, Aristeidis, "Right atrial thrombi complicating haemodialysis catheters. A meta-analysis of reported cases and a proposal of a management algorithm" 27 : 2936-2944, 2012

8 Joe B, "Nephrology and urology of small animals" Wiley-Blackwell 255-280, 2011

9 Hussain N, "Large right atrial thrombus associated with central venous catheter requiring open heart surgery" 2012 : 501303-, 2012

10 Carly Anne Bloom, "Intermittent Hemodialysis for Small Animals" 41 : 115-133, 2011

11 Stephen P. Dibartola, "Fluid, Electrolyte, and Acid-base Disorders" Elsevier Health Sciences 680-704, 2016