Cardiac Perforation by Migrated Fractured Strut of Inferior Vena Cava Filter Mimicking Acute Coronary Syndrome

详细信息    查看全文

• 作者：Chris W. Piercecchi ; MD^a ; ^{cpierc4@emory.edu} ; Julio C. Vasquez ; MD^b ; Stephen J. Kaplan ; MD ; MPH^c ; Jordan Hoffman ; MD^a ; John D. Puskas ; MD^a ; Jacob DeLaRosa ; MD^b
• 关键词：Device removal ; Equipment failure ; Foreign-body migration/complications/diagnosis/aetiology/surgery ; Heart injuries
• 刊名：Heart, Lung and Circulation
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：26
• 期：2
• 页码：e11-e13
• 全文大小：666 K
• 卷排序：26

文摘

We present a rare late complication after inferior vena cava filter (IVC) placement. A 52-year-old woman with an IVC presented with sudden onset of chest pain. Cardiac catheterisation and echocardiography revealed an embolised IVC filter strut penetrating the right ventricle. Endovascular retrieval was considered but deemed unsafe due to proximity to the right coronary artery and concern for migration to pulmonary circulation. Urgent removal of the strut was performed via sternotomy. The postoperative course was uneventful. Two weeks later, she was asymptomatic.Minimally invasive approaches have been described for retrieval of intact IVC filters that have migrated to the right heart but not for embolised filter fragments. We recommend traditional sternotomy as the preferred method of retrieval as it limits the likelihood of further migration or trauma.