Bullet embolisation from the right subclavian vein to the right ventricle: a case report

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Interventional Cardiology

Background:

• Bullet embolism to the heart is an uncommon yet serious complication of penetrating trauma.
• Differentiating direct cardiac injury from venous embolization is crucial for management.
• This scenario presents unique diagnostic and therapeutic challenges in emergency medicine.

Observation:

• A case of a bullet migrating to the heart via the venous system following a gunshot injury.
• The bullet was lodged within the heart, posing an immediate threat to the patient.
• Diagnostic imaging confirmed the bullet's intracardiac location, necessitating urgent intervention.

Findings:

• Successful surgical extraction of the intracardiac bullet was achieved through direct cardiotomy.
• The procedure was performed without the need for cardiopulmonary bypass, minimizing associated risks.
• The patient experienced a favorable outcome following the intervention.

Implications:

• Highlights the possibility of venous bullet embolism to the heart in penetrating trauma.
• Demonstrates the feasibility and potential benefits of direct cardiotomy for intracardiac bullet removal.
• Emphasizes the importance of considering less common injury pathways in ballistics trauma management.