article · JACC Case Reports
BACKGROUND: Implantable chemotherapy ports (ICPs) offer reliable venous access in pediatric oncology but may cause rare, life-threatening complications such as intracardiac dislocation and infective endocarditis (IE). CASE SUMMARY: We report 3 cases of ICP dislocation and IE. Patient 1 was a 4-year-old girl with tricuspid valve destruction who underwent autologous reconstruction using the right atrial appendage. Patient 2 was a 2-year-old girl with a small, nonemboligenic vegetation who was treated with percutaneous port retrieval and antibiotics. Patient 3 was a 22-month-old girl who developed an obstructive pseudonodular mass and experienced sudden cardiac death. DISCUSSION: All patients underwent echocardiography, chest x-ray, and computed tomography imaging. Management included individualized surgical or percutaneous intervention, broad-spectrum antibiotics, and antifungal therapy aligned with febrile neutropenia protocols. This series underscores the need for early detection and tailored treatment after ICP dislocation and IE in children, with autologous valve repair using right atrial appendage offering a growth-compatible option.
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DOI: 10.1016/j.jaccas.2025.105989
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