Cardiovascular foreign body retrieval and its management algorithm

Abstract

Key Clinical MessageApplication of central venous catheters become more common however a rare complication, embolization, can occur which lead to high mortality rate. Therefore, cardiovascular foreign bodies should be immediately remove with a safe and effective method and algorithm. So, we investigate the results of cardiovascular foreign body retrieval in our center based on a designed algorithm. In this case series study, patients who had cardiovascular foreign body embolization were managed by our algorithm. Our approach was based on the time duration of foreign body embolization in cardiovascular system and also its location. If the embolization time was less than 48 h, based on the location of foreign body, insertion site would be right femoral or jugular vein. If the time of foreign body embolization was more than 48 h, echocardiography should be done to assess thrombosis around foreign body. Retrieval was done with snare technique in all patients. Over 12 patients, 9 patient had port catheter foreign body in SVC and atrium, 1 patient had port catheter in atrium, 1 patient had port catheter in pulmonary artery and 1 patient had hemodialysis catheter in inferior vena cava (IVC) and atrium. Foreign body retrieval was successful in all 11 patient. The IVC and atrium were the common site of port catheter fragments. According to our experience, we organize a useful algorithm for retrieval of cardiovascular foreign body based on time of embolization and its location.