QuestionHello I am a 26 yr old female who has a slew of medical issues, but I am really just concerned with the removal and possible replacement of my port-a-cath (power port) after having it in my chest for 3 years. It has been an immense help while going through Lupus, Crohn's and other treatments and I am bummed to say that it hasn't been working lately. It first wouldn't allow any fluid or medication to be pushed nor would it provide a blood return (very unusual for me--my port has always provided a glorious return#, then it would allow medicine and fluids to be pushed through, but again it would not allow a blood return to come through. Finally as I was in the hospital receiving IV antibiotics my port was again accessed and wouldn't ya know it I was unable to have anything pushed through it nor would it give any kind of blood return. So it was concluded that I probably had #and still have) a clot in my port so the doctor ordered a dose of TPA to try and break down the clot so that we could hopefully salvage the port. After sitting with it in for over an hour the nurse tried to break up the clot but nothing was able to be pushed through and it was a bust. So all in all I am seeing my doctor next week to chat about my next step.
What I am wondering is how is a port removed and what are the risks associated with it. Mine is placed in my left upper chest area and the catheter is fed into my jugular vein. I was told that the interventional radiologist created a "pocket" in my muscle on my upper chest and placed my port inside that "pocket" which was strategically placed on a rib for extra support and stability...so basically that port is in there and isn't planning on moving or going anywhere. So now that my port is clogged or clotted I have to have it removed and more than likely replaced. I am assuming that scar tissue and muscle has grown over my port and is covering it up quite well which I am guessing makes the removal a bit trickier then the placement. Not to mention that the catheter is probably surrounded by similar tissues. I am just concerned that when they take both of these out that they will have a high chance or risk of tearing something such as my jugular vein or chest tissue causing some not so pleasant complications.
I would basically just love to know whatever I can about the removal procedure (how long it takes, risks associated, inpatient or outpatient, etc.)? Sorry this ended up so long and probably quite repetitive. Thank you for your help I really appreciate it!
Miranda
AnswerIt is a simple procedure to change one.... the pocket is around the muscle, in the soft tissue. The doc would make a cut down to the portacath, spread the tissue, and remove the unit, leaving the tube (in the vein) in place, then try and pass a guidewire thru the tube, then remove, the tube, replace with the new tube, over the guidewire, then reconnect to a fresh portacath unit and sew it shut.
That is optimal, not worrying about scar tissue, clots, etc. It could be done in an office but no one does them there now.... prob an outpatient surgical center. But it is very outpatient.... only local anesthetic, no real pain, and a dressing in the upper chest. As long as it isn't infected, it can be directly replaced.
If it was infected, it must be removed, the infection treated, then when totally gone, a new portacath placed, from scratch at a later date.
Hope it helps......
