Percutaneous Retrieval of a Fractured Catheter Migrated via a Patent Foramen Ovale With High-Risk Morphology.

Q4 Medicine

JACC. Case reports Pub Date : 2026-10-19 DOI:10.1016/j.jaccas.2026.110637

Yuto Fujimura, Takao Morikawa, Ryo Shigeno, Fumiya Hasegawa, Atsushi Hirohata

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Abstract

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.

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经卵圆孔未闭导管移位的高危形态经皮取出。

背景：中心静脉口导管断裂很少能通过卵圆孔未闭（PFO）进入左心。病例总结：一名70多岁的男性中心静脉导管断裂。心电图门控增强计算机断层扫描证实，碎片横跨从右心室顶点，通过PFO，进入右上肺静脉。由于直接捕获末端被认为是困难的，因此在经食管超声心动图指导下使用线环技术进行经皮取出。导管被拖入下腔静脉，并成功地进入16-F鞘。讨论：在解剖困难的情况下，我们成功地用钢丝环技术收回了断裂的导管。手术前详细的PFO交叉多模态成像对成功检索有重要贡献。关键信息：在PFO患者中，断裂的导管可能会移入左心。多模态成像的术前评估对安全检索至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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