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[Non-surgical extraction of intravascular foreign bodies in children. Experience with 8 cases]
B Herránz Jordán1, R Bermúdez-Cañete Fernández, J I Herráiz Sarachaga
1Servicio de Cardiología Pediátrica, Hospital Ramón y Cajal, Madrid.
Insights
Retrieving intravascular foreign bodies in children using therapeutic catheterization is effective. This minimally invasive technique successfully removed various devices from the heart and vessels in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Interventional Radiology
Background:
- Foreign body retrieval via catheterization is underreported in pediatric populations.
- Congenital heart defects are common comorbidities in children requiring retrieval procedures.
Observation:
- Eight pediatric patients (5 days to 11 years) underwent foreign body retrieval.
- Foreign bodies included catheter fragments, electrode tips, PDA umbrella, and coils lodged in systemic veins, heart chambers, or pulmonary arteries.
Findings:
- Percutaneous femoral vein access with biplane fluoroscopy was utilized in all cases.
- Various snares (Goose-Neck, handmade, Swan-Ganz) and Mullins sheath were employed for retrieval.
- Most foreign bodies were removed percutaneously, with some requiring venous cut-down or minor surgical intervention.
Implications:
- Therapeutic catheterization is the preferred method for intravascular foreign body retrieval in children.
- Minimally invasive techniques can be safely applied to pediatric patients, even those with complex cardiac conditions.
Background And Objectives:
Foreign body retrieval in the catheter room is a useful procedure at any age, but, although its interest, few reports of such technique have been reported in children.
Methods:
We review and present our experience in 8 children, aged 5 days to 11 years, five of them having congenital hearts defects.
Results:
We retrieved 4 catheter fragments, 2 endocardial electrode catheter tips, 1 Rashkind 12 mm. PDA umbrella, and 1 detachable Jackson coil. All of them were placed in systemic veins, right heart chambers or pulmonary arteries. We used biplane fluoroscopy and percutaneous right femoral vein puncture in all cases. Goose-Neck (Microvena Corporation) snares were used in 5 patients, hand made snares in 2 and a Swan-Ganz catheter in one. In 4 cases, the snare was introduced trough a Mullins long sheath and the foreign body pulled into its distal end, in order to bring it out of the femoral vein. Six foreign bodies came off the femoral vein: 4 trough the puncture site and 2 needing a venous cut-down. The two remaining foreign bodies, stopped while pulling at the common iliac vein and a minor surgical procedure was needed for final extraction.
Conclusions:
Therapeutic catheterization is the technique of choice for intravascular foreign body retrieval in children.
