Fragmented Iliac Venous Stent Migration Requiring Tricuspid Valve Replacement.

BACKGROUND

A 36-year-old man with May-Thurner syndrome and a family history of cardiac disease underwent a screening echocardiogram, which revealed a mass in the right ventricle. Upon further imaging, the mass was determined to be an iliac stent migration.

CASE SUMMARY: Our patient presented with a migrated iliac stent 2 years after placement, and a transthoracic echocardiogram visualized a circular and metallic mass. Computed tomography angiography demonstrated stent fragmentation with embolization to the right ventricle, pulmonary vasculature, and inferior vena cava, with entrapment of the intracardiac fragment within the tricuspid subvalvular apparatus.

DISCUSSION: Iliac stent thrombosis and migration are extremely rare, especially with damage to the tricuspid apparatus. However, with prompt imaging and surgical intervention, valvular function can be corrected.

TAKE-HOME MESSAGES: In patients with May-Thurner syndrome, imaging and clinician suspicion are vital in prompt detection and management of an iliac stent migration. This case illustrates the necessity for careful clinical suspicion, timely imaging, and surgical interventions for successful outcomes.