What Type of Vascular Access is a Chest Port?
A chest port (implanted port) provides central venous access through a totally implanted subcutaneous reservoir connected to a catheter that terminates in a deep vein of the chest, specifically in the lower third of the superior vena cava or upper right atrium. 1
Device Structure and Placement
Implanted ports are subcutaneously placed devices consisting of:
- A reservoir implanted in the subcutaneous tissue of the chest with a septum for needle access 1
- A catheter that extends from the reservoir to a deep central vein (typically the subclavian or internal jugular vein) 1
- The catheter tip positioned in the lower third of the superior vena cava or upper right atrium to allow direct delivery into the central circulation 1
Classification as Central Venous Access
Chest ports definitively provide central venous access, not peripheral access. 1 The key distinguishing feature is that the catheter tip resides in the central circulation (SVC or right atrium), which allows for:
- Administration of vesicant and irritant medications that cannot be given peripherally 1
- High osmolarity infusions including parenteral nutrition 1
- Chemotherapy administration, particularly continuous infusions 1
- Blood transfusions and blood product administration 1, 2
Duration Category
Ports are classified as long-term (>3 months) central venous access devices. 1 They are specifically designed for patients requiring long-term, intermittent vascular access and can remain in place for months to years. 1
Key Distinguishing Features from Other Access Types
Ports differ from other central venous catheters in several critical ways:
- Completely subcutaneous: Unlike tunneled or non-tunneled CVCs, there is no external catheter component 1, 3
- Lowest infection rates: Ports have lower catheter-related bloodstream infection rates compared to both tunneled and non-tunneled CVCs 1, 2
- Intermittent access design: Ideal for intermittent therapy rather than continuous access 1
- Cosmetically superior: More aesthetically acceptable than external catheters 1
Flow Rate Considerations
For ports ≥6F, the flow rate is limited by the accessing Huber needle size rather than the catheter lumen itself. 1, 2 This means even smaller gauge ports can deliver adequate transfusion and infusion rates when accessed with appropriately sized needles. 2
Common Pitfall to Avoid
Do not confuse chest ports with peripherally inserted central catheters (PICCs). While both provide central venous access (tip in SVC/right atrium), PICCs are inserted through peripheral arm veins and have an external component, whereas ports are fully implanted and accessed through the chest wall. 1