Salvage of Tunneled Dialysis Catheter-Related Complication by Deep Hypothermic Circulatory Arrest: A Case Report

A BSTRACT This report is about the management of a 61-year-old female patient with end-stage renal disease (ESRD) on regular hemodialysis (HD) since 6 years. The patient presented with thrombo-vegetation around the superior vena cava (SVC) and right atrium on a cuffed tunneled permanent dialysis catheter (TDC) placed via the right internal jugular vein (IJV). Due to intraoperative rupture of SVC-right atrium (RA) junction as a complication of cannulation for initiation of cardiopulmonary bypass (CPB), thrombo-vegectomy was done under deep hypothermic circulatory arrest (DHCA) followed by reconstruction of right SVC-IJV-innominate-brachiocephalic vein using bovine pericardium. The patient was successfully weaned off CPB. New TDC was placed through left subclavian vein.