Malpositioned permacath

Discussion:

Despite appropriate positioning at the cavo-atrial junction on supine fluoroscopy, the tip has migrated superiorly as demonstrated on the post-procedure erect chest x-ray. This often occurs in females with large breasts that migrate inferiorly when going from lying to sitting.

Fortunately in this case the permacath could be advanced under fluoroscopy so the tips are in an appropriate position both supine and erect projections. 

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