Dynamic monitoring of a migrating and penetrating intracardiac foreign body by echocardiography perioperatively

Abstract

Backgroud: Cardiac penetrating injuries caused by migrating foreign bodies are rare. The preoperative and intraoperative locating of these foreign bodies is challenging since their location may change with the continuous beat of the heart. Case presentation: We reported a case of cardiac penetrating injury caused by a self-inflicted needle that migrated from the neck to the heart. The needle was dynamically monitored by both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) perioperatively, which showed a significant location change of the needle in the ventricular wall. The migrating distance of the needle moving into the right ventricle was about 2.0cm. The dynamic monitoring of the needle’s location using echocardiography helped clinical decisions and benefited the patient. Conclusions: Foreign bodies with sharp nature have a tendency to migrate though tissues and lead to serious complications. Echocardiography with a combination of both TTE and TEE has a unique advantage in providing real-time, continuous and accurate monitoring of cardiac foreign bodies. It helps to determine optimal surgical method without radiation hazards, which is worth popularizing in clinical practice.