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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
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Strutting Through: Migration of Fractured Inferior Vena Cava Filter Through the Right Ventricle
Nader Sarkis1, Keith B Allen1, Karthick Vamanan1
1Department of Cardiothoracic and Vascular Surgery, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
Annals of Thoracic Surgery Short Reports
|January 10, 2025
Summary
A fractured inferior vena cava filter strut migrated through a patient's heart over time. The fragment was successfully removed via thoracotomy, highlighting a rare complication of retrievable IVC filters.
Area of Science:
- Cardiology
- Interventional Radiology
- Cardiovascular Surgery
Background:
- Inferior vena cava (IVC) filters are devices used to prevent pulmonary embolism.
- Retrievable IVC filters are designed for temporary implantation and subsequent removal.
- Filter migration is a known but uncommon complication.
Observation:
- A 68-year-old woman presented with back pain 10 years after IVC filter implantation.
- Imaging revealed a fractured IVC filter strut migrating within the right ventricle and pericardial sac.
- The fragment penetrated the right ventricular free wall and extended into the pericardium.
Findings:
- The fractured IVC filter strut demonstrated progressive migration over time.
- The fragment completely traversed the heart, positioning itself within the pericardial sac.
- Surgical removal via left anterior thoracotomy was successful.
Implications:
- This case highlights a rare and severe complication of long-term retrievable IVC filter placement.
- It underscores the importance of vigilant monitoring and timely retrieval of IVC filters.
- Management requires a multidisciplinary approach involving interventional radiology and cardiovascular surgery.
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