Embolism after Inferior Vena Cava Filter Mesh Fragmentation (original) (raw)
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Intracardiac foreign bodies: Diagnosis and management
Intracardiac foreign bodies: Diagnosis and management, 2023
Introduction: As a result of gunshot wounds due to a bullet or shrapnel entering the system of arteries or veins, direct wounds of the heart or vascular structures, as well as embolisms may occur. After entering one of the systemic veins, the bullet or shrapnel can enter the right heart or the pulmonary artery. Shrapnel embolism is a rare condition, usually asymptomatic and is detected accidentally during routine examinations. Due to the fact that the intensity of occurrence of this type of cases is quite rare, it was decided to present such clinical cases. Material and methods: This article reports about 3 patients with intracardiac foreign body. All 3 patients took part in the battles during the Second Karabakh War and were hospitalized as a result of shrapnel wounds received in different parts of the body. In each of the patients, the lesion area was different, but as a result of venous migration, the movement of a foreign body (metal fragment) in the heart cavity was noted. In two patients, the foreign body was removed by open surgery (connection to a heart-lung machine) due to the presence of symptoms, but one patient was under observation due to the absence of symptoms. Results: Bullet or shrapnel embolism is a very rare complication of gunshot wounds, occurring in about 0.3% of cases. These emboli often cause antegrade migration into the arterial system. However, in about 20% of cases, migration into the venous system can also occur. Venous embolism often results in foreign body migration into the right heart or the pulmonary artery. The diagnosis in these cases is often established by chance, but in some cases, arrhythmias and valve defects can occur due to exposure to a foreign body. The identification of such cases depends on the symptoms. A foreign body can be removed by an open method, as well as by invasive methods. In some cases, it is possible to keep the foreign body under control when it does not cause any symptoms. In the clinical cases we mentioned, we also mentioned the management of cases of foreign bodies entering the venous system from peripheral zones of penetration.
The accidental expansion of an inferior vena cava filter which migrated to the pulmonary artery
Turkish Journal of Thoracic and Cardiovascular Surgery, 2012
Derin ven trombozu (DVT), ölümcül pulmoner tromboembolizm ile sonuçlanabilir. Antikoagülan tedaviye uygun olmayan hastalarda vena cava inferior filtresi tromboembolik olayları önlemek için kullanılmaktadır. Ancak bu filtrelerin en büyük dezavantajı pulmoner artere yer değiştirmesidir. Bu yazıda, vena cava inferior filtresi pulmoner artere yer değiştirdikten sonra kazara açılan 68 yaşında bir kadın olgu sunuldu. Anah tar söz cük ler: Derin ven trombozu; embolizasyon; yer değiştirme; vena cava inferior fitresi.
World Journal of Cardiovascular Surgery
Inferior vena cava (IVC) filters have since been implanted in the 1970s. The aim of implantation is to prevent the occurrence of fatal pulmonary embolism (PE). However, fatal pulmonary embolisms have been occurring after filter insertion. The mechanism is that either a thrombus or an embolus was already located cranial to the site of deployment of the filter within the inferior vena cava. And so after the filter implantation significant embolism can still occur. We present the case of a 62-year-old woman who had an IVC filter but died two weeks later from pulmonary embolism, through an unusual mechanism. The patient had a fracture of the left tibia, had open reduction and internal fixation developed pulmonary embolism secondary to deep vein thrombosis of the left lower limb. Anticoagulation was started, an IVC filter was inserted and she was discharged home with a therapeutic INR. However, she passed away two weeks later from pulmonary embolism, through the unusual mechanism of thrombus propagation across the IVC filter. The clinical significance of this article is to draw clinicians' attention to the existence of another mechanism of fatal pulmonary embolism after an IVC filter insertion. The thrombus can propagate across the IVC filter leading to fatal pulmonary embolism.
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 1996
Purpose This report deals with the case of a patient who presented persistence of left superior vena cava (LSVC). This disorder was discovered following placement of a catheter in pulmonary artery via the left subclavian vein. Clinical features The patient was a 67-yr-old woman who, while in the intensive care unit after undergoing coronary revascularization with extracorporeal circulation, required pulmonary artery catheterization to guide resuscitation. Placement of the catheter proved to be difficult as the advance of the catheter was impeded. A normal pulmonary artery pressure wave was eventually detected at a distance of approximately 70 cm. Chest x-ray showed a catheter route suggestive of persistent LSVC. Conclusion A diagnosis of persistent LSVC should be considered whenever there appears to be some obstacle to central venous or pulmonary artery catheterization, especially in patients with congenital heart disease, since this disorder can have important clinical consequences. Objectif Cette observation décrit la persistance de la veine cave supérieure gauche (VCSG). L’anomalie a été découverte pendant l’installation d’un cathéter dans l’artère pulmonaire par ponction de la veine sous-clavière gauche. Caractéristiques cliniques Il s’agissait d’une patiente de 67 ans déjà admise à l’unité de soins intensifs après une chirurgie de revascularisation coronarienne sous CEC chez qui la réanimation nécessitait une cathétérisation de l’artère pulmonaire. L’installation s’est avérée laborieuse suite à l’arrêt de la progression du cathéter. Un courbe de pression artérielle pulmonaire a été décelée éventuellement après un trajet d’environ 70 cm. La radiographie pulmonaire était compatible avec la persistance de la VCSG. Conclusion Un diagnostic de persistance de VCSG doit être envisagé chaque fois qu ’on rencontre un obstacle à la progression d’un cathéter veineux central ou artériel pulmonaire, surtout chez les porteurs d’anomalies cardiaques congénitales à cause des conséquences sérieuses que cette anomalie peut entraîner.
Fractured Metal Wire in the Right Ventricle, a Cause of Cardiac Tamponade
Open Journal of Anesthesiology, 2012
Cardiac tamponade is a surgical emergency. This case report illustrates a very peculiar situation, where the patient's condition deteriorated rapidly after arrival to the emergency room with a diagnosis of cardiac tamponade. Patient was promptly taken to the operating room and after evacuation of the pericardial effusion, had to be placed on cardio-pulmonary bypass in order to find and treat the source of the bleeding. A wire fragment was recovered from the right ventricle. This was identified as a broken piece of a guide wire used in placing a central venous catheter several years earlier.