Title：Long term central venous catheters for haemodialysis causing an extra-cardiac right-to-left shunt.

Abstract：Central venous catheters can provide long-term access for haemodialysis patients who cannot have an arteriovenous fistula or graft fashioned. However, long-term central venous catheter use for haemodialysis may lead to complications including central venous stenosis, and superior vena cava obstruction in its worst form. Here, we describe the case of a patient on haemodialysis via central venous catheters for over 20 years, in whom chronic superior vena cava obstruction led to the development of mediastinal collateral vessels. These drained deoxygenated systemic venous blood into the oxygenated pulmonary venous system. Over time, this caused a significant right-to-left shunt and resulting hypoxaemia. This is the first reported case of central venous catheters used for haemodialysis resulting in an acquired, extra-cardiac, right-to-left shunt.

题名：透析用长期导管导致心外右向左分流

摘要：传统上，因为隧道式中心静脉导管放置迅速，可以立即使用，用于提供紧急血液透析通道。然而，对于没有动静脉瘘或移植物血管的长期血液透析患者来说，中心静脉导管可能是必要的。随着时间的推移，许多并发症与中心静脉导管的使用有关，包括中心静脉狭窄和上腔静脉阻塞。在此，我们描述了一例20多年来通过中心静脉导管进行血液透析的患者，后逐渐发展为上腔静脉阻塞，导致纵隔侧支形成。由于这些含有脱氧血液的侧支血管流入肺静脉，这导致了心外右向左分流(全身到肺)。而该病例是透析用中心导管所致心外右向左分流并发症的首次报道。

题录信息：Seneschall C, Ferguson C, Gopalan D, Salisbury E. Long term central venous catheters for haemodialysis causing an extra-cardiac right-to-left shunt. J Nephrol. 2022. 35(5): 1521-1524.