At facilities that offer cardiac surgery services, minimally invasive cardiothoracic surgery is fast becoming commonplace, particularly in aortic, tricuspid, and mitral valve procedures. Use of a coronary sinus catheter, a specialized central venous catheter, to monitor hypothermic depth and provide retrograde cardioplegia has been widely adopted at Tufts Medical Center. Complications of coronary sinus catheter insertion are considered rare but are well documented. In contrast, complications of catheter removal, such as the catheter fracture that we report here, are not well described in the literature. In this case, the catheter tip was retrieved without further patient harm or additional invasive interventions.

Surgical exclusion of the left atrial appendage (LAA) for stroke prevention in atrial fibrillation is frequently incomplete and remains to be optimized. We present a man who did not tolerate anticoagulant and failed percutaneous occlusion. Intraoperative echocardiographic contrast was used to assist surgical exclusion. Follow-up showed a persistent occlusion.

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