JACC. Case reports · 2026
Percutaneous Retrieval of a Fractured Catheter Migrated via a Patent Foramen Ovale With High-Risk Morphology.
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Fujimura Yuto, Morikawa Takao, Shigeno Ryo, Hasegawa Fumiya, Hirohata Atsushi
Аннотация
BACKGROUND: A fractured central venous port catheter can rarely migrate into the left heart via a patent foramen ovale (PFO).
CASE SUMMARY: A man in his 70s presented with a fractured central venous port catheter. Electrocardiogram-gated contrast-enhanced computed tomography confirmed that the fragment straddled from the right ventricular apex, through a PFO, into the right upper pulmonary vein. Because direct snaring of the ends was considered difficult, percutaneous retrieval was performed under transesophageal echocardiography guidance using the wire-loop technique. The catheter was dragged into the inferior vena cava and successfully retrieved into a 16-F sheath.
DISCUSSION: In a situation where direct snaring was anatomically difficult, we successfully retrieved the fractured catheter with the wire-loop technique. Detailed preprocedural multimodality imaging of the PFO crossing significantly contributed to successful retrieval.
TAKE-HOME MESSAGES: In patients with a PFO, a fractured catheter can migrate into the left heart. Preprocedural evaluation using multimodality imaging is crucial for safe retrieval.
CASE SUMMARY: A man in his 70s presented with a fractured central venous port catheter. Electrocardiogram-gated contrast-enhanced computed tomography confirmed that the fragment straddled from the right ventricular apex, through a PFO, into the right upper pulmonary vein. Because direct snaring of the ends was considered difficult, percutaneous retrieval was performed under transesophageal echocardiography guidance using the wire-loop technique. The catheter was dragged into the inferior vena cava and successfully retrieved into a 16-F sheath.
DISCUSSION: In a situation where direct snaring was anatomically difficult, we successfully retrieved the fractured catheter with the wire-loop technique. Detailed preprocedural multimodality imaging of the PFO crossing significantly contributed to successful retrieval.
TAKE-HOME MESSAGES: In patients with a PFO, a fractured catheter can migrate into the left heart. Preprocedural evaluation using multimodality imaging is crucial for safe retrieval.