Transesophageal echocardiography-guided implantation of totally implantable venous access devices via the internal jugular vein: retrospective analysis of 297 cases in pediatric patients

Background Accurately positioning totally implantable venous access device (TIVAD) catheters and reducing complications in pediatric patients are important and challenging. A number of studies have shown methods for locating the tip of the TIVAD catheter. We assessed the success and complications of TIVAD implantation guided by transesophageal echocardiography (TEE) via the internal jugular vein (IJV) for 294 patients in this retrospective study. Methods From May 2019 to March 2021, 297 cases of TIVADs in our hospital were analyzed in this observational, non-randomized, single-center study. The position of the catheter tip under TEE and chest radiography and rates of periprocedural, early, and late complications were evaluated. Results The implantation was successful in 242 (82.3%) cases which was in a proper position, and the results were consistent with those of postoperative chest radiography. A total of 72 complications were recorded. Of these, 1 case had a perioperative complication, 66 had early complications, and 5 had late complications after port implantation. The most common complications were local infection and catheter malposition, namely 10 (13.9%) cases of incision infection and 58 (80.6%) cases of catheter malposition. In total, 6 (8.3%) cases of port explantation were required. Conclusion Confirmation of proper TIVAD catheter positioning by TEE through an internal jugular approach in children was accurate and safe. Keywords: Totally implantable venous access device (TIVAD), Transesophageal echocardiography (TEE), Complication, Catheter tip position, Chest radiography