Subclavian mediport

Patient was met in the preoperative holding area all questions were answered patient was marked appropriately, consent was confirmed. Patient was transported to the operating room placed in the table supine secured with straps bony areas padded. Monitored anesthesia care was administered. The [side] chest was prepped and draped normal sterile fashion. Timeout was done all were in agreement. The subclavian was accessed with introducer needle return of dark nonpulsatile blood. J-wire was advanced. C arm x-ray showed the wire traversing into the IVC. Skin nick was made dilator sheath was placed and peeled while the tubing was placed. Next an incision was made just inferior to this and a pocket was made over the level of the pectoralis muscle fascia. A tunnel dilator was used to tunnel the tubing to this pocket. Next final confirmation of depth was done using fluoroscopic guidance terminating the tubing at the right atrial junction. The port was accessed with a Huber needle and easily return blood and was flushed. Final flush was done with 3 cc heparinized saline. The tubing was attached to the reservoir port and was secured to the pectoralis fascia using two interrupted 2-0 Vicryl. The incision was closed in layers with 3-0 Vicryl, 4-0 Monocryl, Dermabond and the percutaneous access site in the same way. Patient was liberated from monitored anesthesia care and transported to the ASU in stable condition. Postop x-ray was ordered.

Dr. [attending] was present and scrubbed for the entire procedure