Mini-sternotomy for direct right atrial dialysis catheter placement – Full Text

"We report the case of a pediatric patient with kidney failure and bilateral central venous occlusion, in whom conventional dialysis access was no longer feasible. Following multidisciplinary evaluation, a dialysis catheter was surgically inserted directly into the right atrium via a lower mini-sternotomy" Nucera et al (2025).

"We report the case of a pediatric patient with kidney failure and bilateral central venous occlusion, in whom conventional dialysis access was no longer feasible. Following multidisciplinary evaluation, a dialysis catheter was surgically inserted directly into the right atrium via a lower mini-sternotomy" Nucera et al (2025).

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Mini-sternotomy for direct right atrial dialysis catheter placement

Abstract:

We report the case of a pediatric patient with kidney failure and bilateral central venous occlusion, in whom conventional dialysis access was no longer feasible. Following multidisciplinary evaluation, a dialysis catheter was surgically inserted directly into the right atrium via a lower mini-sternotomy. A custom-made bovine pericardial conduit was used to facilitate extrathoracic tunnelling and protect the catheter. The procedure was technically successful, and the catheter remained functional postoperatively. This case highlights a viable salvage option for dialysis access in children with exhausted vascular access sites.

Reference:

Nucera M, Tschumi S, Siepe M. Mini-sternotomy for direct right atrial dialysis catheter placement in a child with central venous occlusion. Pediatr Nephrol. 2025 Dec 9. doi: 10.1007/s00467-025-07104-6. Epub ahead of print. PMID: 41364179.