Dilemma with the route of venous access for hemodialysis catheter insertion in a patient with dilated ischemic cardiomyopathy treated by cardiac resynchronization therapy.

Abstract
A 68 year old patient requiring urgent dialysis due to raising potassium was referred to our center. He had 3 indwelling catheters in his heart via right subclavian vein. His left subclavian and interngal jugular veins were thrombosed possibly due to earlier indwelling catheters. The dilemma was if right internal jugular venous route could be used for insertion of dialysis catheter. Under fluoroscopic guidance, right internal jugular vein was cannulated with the dialysis catheter without problems. This case is being presented to highlight the need for imaging both by ultrasound and radiography during the procedure.
Description
Keywords
Cardiac resynchronization therapy, Chronic kidney disease, Hemodialysis catheter
Citation
Ashokananda Devanahalli, Chakravarthy Murali, Gowda Mohan, Maddirala Pavani, Sripar Sanjay. Dilemma with the route of venous access for hemodialysis catheter insertion in a patient with dilated ischemic cardiomyopathy treated by cardiac resynchronization therapy. Annals of Cardiac Anaesthesia. 2016 July; 19(3): 389-391.