Retrieving a lost needle in the descending aorta during hemi-arch replacement

Area of Science:

• Cardiovascular Surgery
• Medical Device Technology

Background:

• A 73-year-old male patient presented with moderate aortic insufficiency and aortic root/ascending aorta dilatation.
• The patient underwent a modified Bentall procedure and hemi-arch aortic replacement.

Observation:

• A surgical needle was inadvertently lost during the open distal anastomosis of the ascending aorta.
• Imaging (radiography and transesophageal echo) confirmed the needle's location within the descending aorta.

Findings:

• The lost needle was successfully retrieved using a snare catheter inserted via the graft branch.
• Fluoroscopic guidance was utilized for precise needle localization and retrieval.
• The graft branch remained intact, and no new incision was required.

Implications:

• This case demonstrates a successful minimally invasive retrieval of a foreign object from the descending aorta during complex aortic surgery.
• The technique highlights the utility of endovascular retrieval methods in managing intraoperative complications.
• This approach potentially reduces patient morbidity by avoiding repeat sternotomy or new surgical sites.