Migration of an Implanted Venous Catheter Fragment as an Unexpected Cause of Cough: A Case Report

Abstract

Introduction: Oncology patients use implantable central venous catheters for long-term venous access. Although generally safe, they may present mechanical complications such as fracture and migration, which can lead to atypical symptoms like chronic cough. Case report: We describe a patient with stage IIA infiltrating ductal carcinoma of the breast, Luminal B subtype, who first received neoadjuvant chemotherapy with doxorubicin and cyclophosphamide and then weekly paclitaxel before having a radical mastectomy. She later underwent a radical mastectomy. The central venous catheter, placed for treatment, fractured and migrated with an 11 cm fragment lodged in the right ventricle and atrium. The patient presented with chronic cough as the only symptom. The patient did not receive anticoagulation or undergo prior echocardiography. A right heart catheterization was carried out under neuroleptic sedation and local anaesthesia, successfully retrieving the fragment using a multi-snare loop catheter. Conclusion: Fracture and migration of central venous catheters are rare but potentially serious complications that should be considered in patients with nonspecific symptoms such as cough. Retrieval via cardiac catheterization is an effective and safe treatment.