Echocardiographically guided removal of an intracardiac foreign body.

Abstract

BACKGROUND: Foreign bodies lodged in the heart can easily be missed during surgical repair of penetrating cardiac wounds. SUMMARY: We report the use of intraoperative echocardiography to identify and accurately locate a small cardiac foreign body. Our patient had a fragment of a drill bit lodged in his left atrium as the result of an industrial accident. He initially underwent emergency median sternotomy because of acute tamponade, but the foreign body was not found, and he subsequently required a second procedure to remove it. Intraoperative transesophageal and epicardial echocardiography during the second procedure confirmed the position of the metallic fragment, excluded the possibility of other lodged foreign particles, and ruled out other types of penetrating injury to the heart. CONCLUSIONS: Intraoperative echocardiography should be standard procedure in the removal of intracardiac foreign bodies.