Thrombus at the Tip of a PICC Catheter Entangling the Tricuspid Valve and Causing Severe Tricuspid Regurgitation: A Case Report

Peripherally inserted central catheters (PICCs) are widely utilized for central venous access in pediatric patients, yet thrombotic complications remain underrecognized. We present the case of life-threatening tricuspid valve entanglement caused by a dislodged PICC tip thrombus in an 8-month-old infant with congenital heart disease. Following cardiac surgery, the patient developed refractory pulmonary hypertension and sepsis, culminating in circulatory collapse triggered by acute tricuspid regurgitation. Emergency thrombectomy under cardiopulmonary bypass transiently stabilized hemodynamics, but the patient ultimately succumbed to multiorgan failure. This case underscores the critical need for heightened vigilance regarding PICC-related thrombosis in high-risk pediatric populations, particularly those with congenital heart defects and impaired hemodynamics. Echocardiographic surveillance and multidisciplinary management are emphasized as pivotal strategies for early intervention.