The bedside placement of a peripherally inserted central catheter is contraindicated in patients with a total artificial heart.
An emergent situation prohibiting radiographic guidance of central line placement in a patient with a total artificial heart is described.
Techniques used to successfully place a peripherally inserted central catheter are noted to help guide clinicians faced with vascular access challenges in a patient with a total artificial heart.
Bedside insertion of a peripherally inserted central catheter (PICC) in a recipient of a total artificial heart is contraindicated due to the possible catastrophic event of the catheter jamming the total artificial heart pump and creating a stoppage of the pump, and consequently, death of the patient. A patient with a total artificial heart suffered complications intraoperatively and postoperatively that necessitated removal of the vascular access devices from the patient’s bilateral femoral veins. The patient was deemed hemodynamically unstable and unsafe to travel to interventional radiology for vascular access placement. In a multidisciplinary effort, the vascular access team, intensivists, and the cardiothoracic surgical team worked together to use best practice for the bedside placement of a PICC safely and without complications. Though not the ideal conditions and scenario for a PICC placement, this case study describes a method of PICC line placement that can be used when limited options are available.