European Heart Journal Advance Access originally published online on May 30, 2008
European Heart Journal 2008 29(22):2732; doi:10.1093/eurheartj/ehn239
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Unusual use of a standard percutaneous transluminal coronary angioplasty balloon catheter to the rescue
Deutsches Herzzentrum und I. Medizinische Klinik, Klinikum rechts der Isar – Technische Universität München, Lazarettstraße 31, 81675 München, Germany
* Corresponding author: Tel: +49 89 12180, Fax: +49 89 1218 4593, Email: vorpahl{at}dhm.mhn.de
Radical mastectomy because of a right-sided invasive ductal breast carcinoma was performed in a 72-year-old patient. After the seventh cycle of combined chemo- and immunotherapies (docetaxel, carboplatin, and trastuzumab), her chest X-ray presented the complication of the broken venous catheter-tip dislocated into the right atrium reaching through the right ventricle into the pulmonary artery (Panel A). The danger of complications (e.g. rhythm disturbances, laceration, infection, and apposition of thrombotic material) demanded immediate recovery of the broken catheter tip. Unfortunately, the conventional rescue by a noose catheter resulted in the fragmentation into two parts embolizing into peripheral branches of the left and right pulmonary arteries. To avoid a surgical removal, a standard coronary-guiding catheter was positioned via the pulmonary artery in front of the ostium of one catheter fragment. A percutaneous transluminal coronary angioplasty (PTCA) guide wire was introduced into the lumen of the fragment. Over the guide wire, a PTCA balloon catheter was placed and inflated inside the port fragment (Panel B). The inflated balloon catheter was pulled out and the catheter fragment was recovered from the pulmonary artery through the right ventricle, atrium, and the vena cava inferior over a 10F sheet (Panel C).
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