Removal of a bullet from the right heart using controlled embolization to a peripheral vein

A man received a gunshot wound to his face without an exit wound. His initial chest roentgenogram was normal, but a second one revealed a bullet in the chest. Under fluoroscopic monitoring, we moved the projectile from the right heart cavities to the right femoral vein, where it was removed with the patient under local anesthesia. We describe the usefulness of controlled venous embolization as the initial approach for the removal of bullets within the venous system.