Percutaneous Retrieval of an Air Bullet From the Left Ventricle

Elasfar, Abdelfatah; Naeim, Hesham Abdo; Hussein, Mohamed; Tolba, Maher; Uddin, Mohamed Nizam; Alharbi, Ibraheem; Abuelatta, Reda

doi:10.1016/j.jcin.2018.04.040

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“…concluded that venous bullet emboli should be removed endovascularly whenever technically possible. In our centre, we reported a case of successful percutaneous removal of an air bullet partially embedded in the LV side of the interventricular septum, a thrombus was formed around the bullet, and the risk of embolism was present 9 . We decided to extract the bullet rather than to leave in place.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature

Naeim¹,

Abuelatta²,

Sandogji³

et al. 2019

European Heart Journal - Case Reports

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Background Gunshots embolizing to the heart is a rare occurrence. We report a case of percutaneous retrieval of a gunshot bullet from the right ventricle (RV) cavity of a 40-year-old lady. To the best of our knowledge, this is the first case to be reported with a right supraclavicular inlet of the bullet and successful percutaneous retrieval using a snare from the RV cavity. Case summary A 40-year-old female patient was referred to our cardiac centre from a general hospital with a gunshot injury 8 days prior. On arrival, she was haemodynamically stable, there was an inlet wound at the right supraclavicular area. Transthoracic echocardiography revealed the bullet in the RV cavity. Under conscious sedation, right femoral vein access succeeded to retrieve the shot from the RV to the groin. The bullet slipped out and resnared from the right internal iliac vein and came out safely from the right femoral vein through the 24-Fr sheath. The vein was closed using a figure of 8 suture. The patient discharged home after 2 days. Discussion Bullet emboli to the heart are rare, endovascular retrieval of a bullet from the right ventricular cavity is feasible and relatively safe; however, more research is required. Echocardiography during the procedure is strongly recommended to early detect any complications. Accurate use of available tools such as X-ray, echocardiography, computed tomography, and fluoroscopy is a must for precise diagnosis.

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Section: Discussionmentioning

confidence: 99%