Port catheter fracture and embolisation without prior evidence of pinch-off syndrome

A central venous port catheter inserted infraclavicularily via the subclavi an route may be compressed by the clavicle and the adjacent first rib. It's appearance on chest x-ray has been previously described as the 'pinch-off phenomenon' and requires the removal of the catheter due to a significant r isk of fracture. We report the case of a catheter fracture without prior ev idence of pinch-off. The free catheter fragment was embolized into the righ t atrium and caused pericardial effusion. Percutaneous removal of the fragm ent was attempted but failed and thus open heart surgery with a cardiopulmo nary bypass was required. The myocardial lesion caused by the catheter was sutured.