Dislodgment is a major drawback with large-bore Malecot catheters. A locking mechanism with a suture affixed to the distal portion of the mushroom tip is described. In a 32-month period, 17 Malecot catheters with locking mechanisms were placed in 15 patients. One catheter dislodged as a result of suture failure. A variation in design prevented subsequent failure of sutures. This simple locking mechanism prevents collapse of the catheter wings and thereby maintains catheter placement.