The Long-Term Central Venous Port for Home Parenteral Nutrition Was Removed Under Cardiopulmonary Bypass: A Case Report

Abstract Introduction: Potential complications of long-term use of a central venous port include catheter related bloodstream infection, thrombus formation, and vena cava occlusion. Here, we report an extremely rare case of a patient with Crohn’s disease in whom a central venous port was removed under cardiopulmonary bypass because of intimal adhesion of the superior vena cava. Case presentation: A 58-year-old man with a history of Crohn’s disease since the age of 17 required emergency hospitalization because of disease exacerbation. A central venous port was implanted, and the patient was started on home parenteral nutrition at 30 years of age. At 58 years of age, he was scheduled for elective surgery because of abscess formation and stenosis around the colostomy site. He had remittent fever, and we suspected catheter-related bloodstream infection. We encountered strong resistance and postponed central venous port removal; we suspected an adhesion in the thoracic cavity. An endovascular procedure would have been difficult because of the presence of sepsis and the lack of available information about the implanted central venous port. The following day, the patient underwent central venous port removal under cardiopulmonary bypass. Catheter tip cultures obtained during surgery were positive. After the removal of the central venous port, the fever resolved steadily. Conclusion: Regular assessment or replacement may be advisable after several years of use and removed as soon as possible when unnecessary.