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[Removal of an intracardiac foreign body]
Insights
Central venous catheter fragments migrated into the heart require removal. Transvascular catheter techniques are effective but carry risks, sometimes necessitating surgical intervention for intracardiac foreign bodies.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Device Complications
Background:
- Intracardiac foreign bodies, specifically migrated central venous catheter fragments, pose a significant clinical challenge.
- Accidental transection of central venous catheters can lead to embolization within the cardiovascular system.
Observation:
- Four cases of intracardiac foreign bodies resulting from severed central venous catheters are presented.
- Treatment strategies included surgical removal in one patient and transvascular catheter techniques in others.
Findings:
- Transvascular catheter removal was attempted in three patients.
- A complication occurred where a grasping catheter entangled with a tricuspid valve chorda, requiring combined surgical removal of the foreign body and the retrieval device.
Implications:
- Transvascular catheter retrieval is a viable option for intracardiac foreign bodies but requires careful technique to avoid complications.
- Complex cases may still necessitate open surgical intervention, highlighting the importance of procedural planning and risk assessment.
Abstract:
Four patients with intracardiac foreign body, in whom central venous catheter was accidentally cut and its fragment was migrated into the cardiovascular system, are presented. One patient was surgically treated. Other patients were treated using transvascular catheter technique. In one of three patients, however, a chorda of tricuspid valve was hooked by a grasping catheter and the patient was forced to surgical removal of both a catheter fragment and the grasping catheter. We discussed the method and problems to remove intra-cardiovascular foreign body.