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CIDP, infusions of gamugard, failed port, blood clot above heart. Risks involved during surgery ?

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Practicing since : 2001
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My son (37) with CIDP receives weekly infusions of gamugard. His port failed three weeks ago. It will have to be surgically removed. They are lookin at his neck. He has now been told he has a blood clot above his heart and is receiving injections to thin the blood. Third injection tomorrow. Surgery is scheduled for XXXXXXX 13th as far as I know that has not changed. What risks does he face right now? He lives in a northern city without the resources available at a larger teaching hospital. Should he travel for this serious or fairly routine surgery?
Posted Wed, 2 May 2012 in Hypertension and Heart Disease
Answered by Dr. Rakhi Tayal 22 minutes later
Thanks for writing to us.
The removal and insertion of a fresh portacath is a day care surgery usually done under local anaesthesia or mild sedation. It is a very minor and harmless routine surgical procedure done in patients in whom repeated medicines need to given and blood samples need to be taken.
Your son need not travel to a specialized or higher center for such a minor procedure. Rest assured there is minimal pain after the procedure which can be easily controlled by routine pain killers.
I hope this information has been both informative and helpful for you. If there are additional concerns, I am available for your followups.

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Follow-up: CIDP, infusions of gamugard, failed port, blood clot above heart. Risks involved during surgery ? 1 hour later
Thank you for identifying the portacath procedure...about the blood clot above his heart..he tells me that may have been the reason the portacath failed. How XXXXXXX is the clot, should he be driving? (I work in the Arctic and he lives in Ontario.)
Answered by Dr. Rakhi Tayal 1 hour later

Thanks for writing back.

If the portacath was inserted in the shoulder or in the neck, both ways the clot present above his heart when in central vein?

Gamma globulins are given intravenously and slowly. Hence the risk of thrombotic events are rare. The catheter removal might help in the dissolution of the clot. So there is no risk to his life.

However presence of clot inside any central blood vessel might have worrisome consequences in case it dislodges and gets stuck. I believe he should not drive alone at least some should help him especially if it long drive.

Some of the questions require detailed explanation to answer specifically, size of the clot, which vein is the catheter inserted, the general condition of your son are also important.

Sincerely hope it will help. Wishing your son an early recovery.
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