Malposition of Central Venous Pressure Catheter as a Rare Cause of Tricuspid Valve Prosthesis Malfunction: A Case Report malfunction; a case report

Prosthetic valve malfunction is a hazardous clinical entity that needs early diagnosis and management. Hereby, we present a case of tricuspid valve (TV) malfunction due to interaction of central venous pressure (CVP) catheter with TV leaflets. Our case was a 38-year-old male who referred to our center with the diagnosis of TV malfunction. Confirming the diagnosis of TV malfunction, intravenous Heparin was initiated. Anticoagulation therapy was discontinued early due to the development of significant headache in the setting of subarachnoid hemorrhage. Due to contraindication of anticoagulation therapy, he underwent redo TV. On the 4th post-operative day, echocardiography examination illustrated significant increase in gradients of TV prosthesis. At this time, fluoroscopy depicted interaction of CVP catheter with TV leaflets due to its cardiac advancement resulted in fixed TV leaflets in semi-open position. By extraction of CVP catheter the TV gradients improved immediately. Malposition of CVP catheter or large CVP catheter could be considered as one of the rare causes of TV malfunction. Repositioning of CVP catheter brings dramatic improvement in this case.