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Updated: Jan 8, 2026

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Transvenous Bullet Embolism: A Case Report of a Successful Right Ventricular "Bulletectomy"
Omar Toubat1, Nikhil Ganjoo1, Joav Birjiniuk1
1Division of Cardiovascular Surgery, Department of Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background:
Bullet emboli are a rare complication of ballistic trauma where ballistic fragments penetrate the vascular system and migrate to distant sites.
Case Summary:
We present a case of a 35-year-old man with a gunshot wound to the right upper back. Despite hemodynamic stability, serial imaging demonstrated bullet migration from the right supraclavicular area to the right ventricular apex. Surgical retrieval via median sternotomy and central cardiopulmonary bypass was successfully performed.
Discussion:
This case highlights the importance of serial imaging and review indications for surgical management of hemodynamically stable patients with bullet embolisms.
Take-Home Messages:
Surgery is indicated for the management of bullet embolisms in stable patients when significant migration occurs. Diagnostic transesophageal echocardiography is critical for confirming the intracardiac location of such fragments and guiding intervention.
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