Removal of a Pleuroamniotic Shunting Tube Dislodged in Thoracic Wall With a Bilateral Approach

Abstract

Fetal thoracoamniotic shunting (TAS) is a promising treatment for fetal hydrothorax. However, displacement of the shunting catheter is one of the major complications. We experienced removal of a catheter that had remained in the thoracic wall of a patient.
A 44-day-old girl received TAS for bilateral hydrothorax at the age of 31 weeks and 1 gestational day. However, she underwent bilateral TAS again two days later because of reaccumulation of pleural effusion. She was born at 31 weeks and 6 gestational days by caesarian section due to accumulation of left pleural fluid and decreased fetal heart rate. A catheter was observed on her right chest wall, whereas another was palpated subcutaneously after birth. Chest CT was taken at age 43 days, and removal of the remnant catheter was done one day later. Two incisions were made on the right lateral and dorsal thoracic wall, and muscular tissues that grew into the basket portion of the catheter were dissected bilaterally. No intra- and post-operative complication was observed. Pre-surgical investigation for location of the remnant catheter with CT and dissection of intra-basket muscular tissues might have contributed to uncomplicated removal of the catheter.