This is an organized thromus over ablocked hemodialysis catheter, in a 64 years old male with chronic renal failure. Patient faied two trials of threrapeatic anticoagulation. Nephrologist were uncomfortable to repace the catheter due to huge size of thrombus on echo which is occupaying most of right atruim cavity.
Eventually I removed the thrombus manually from right atruim bu beating on pump surgery, patient did well.
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