Thoracoscopy-Assisted Removal of a Thoraco-Amniotic Shunt Catheter With Both Basket Tips Stuck on the Thoracic Wall and Mediastinal Pleura

Abstract

A baby boy with pleural effusion was delivered at 33 weeks of gestation. Because of pleural effusion at 31 weeks of gestation, he was referred to our hospital. Because of reaccumulation of pleural effusion after thoracentesis and aspiration, thoraco-amniotic shunting (TAS) was performed, but the entire double-basket catheter apparently dropped into the pleural cavity. After birth, one basket end of the catheter was found within the thoracic wall, and the catheter was surgically removed at 26 days of age. Because the catheter could not be released by dissection of the basket within the thoracic wall, the other basket end, firmly stuck to the mediastinal pleura in the thoracic cavity, was dissected and removed by a thoracoscopy-assisted procedure. Dislodgement of a double-basket catheter is one of the complications of TAS. Not all catheters with one basket buried in the thoracic wall can be removed just by thoracic wall dissection. In that case, thoracoscopic assistance is very useful to inspect the catheter in the pleural cavity and remove it safely.