Conversion of indwelling chest port catheters to tunneled central venous catheters

PURPOSE: To determine the safety and efficacy of the conversion of subcutan eous chest wall infusion ports to tunneled central venous catheters, MATERIALS AND METHODS: During a period of 34 months, 67 patients were refer red for conversion of indwelling subcutaneous chest wall ports to tunneled central venous catheters as part of a bone marrow transplant protocol. Six patients were deemed unacceptable for conversion and the remaining 61 under went successful conversion. All patients had functioning surgically placed single-lumen (n = 50) or double-lumen (n = 11) chest ports, which were remo ved to maintain the original venous access sites for placement of a tunnele d central venous catheter, incorporating the chest wall pocket for tunnelin g, in 46 patients (75%), A new tunnel was created in the other 15 patients. There were no immediate complications and all patients were followed until catheter removal or patient demise with the catheter in place, RESULTS: 57 of 61 (93%) catheters were used without evidence of infection f or 23-164 days (mean, 57 d) after placement. Two (3%) were removed (both at 26 days) because of persistent neutropenic fever without physical signs or laboratory evidence of catheter infection, and two (3%) were removed (at 1 1 and 77 days) because of proven catheter infection, yielding an overall in fection rate of 1.2 per 1,000 catheter days. Two catheters required exchang e and two required stripping because of decreased function, resulting in an overall catheter-related complication rate of 2.4 per 1,000 catheter days, CONCLUSIONS: Indwelling subcutaneous chest wall infusion ports can be safel y converted to tunneled central venous catheters, even in an immunocompromi sed patient population, with a low risk of complications such as infection.