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Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature

BACKGROUND: Gunshots embolizing to the heart is a rare occurrence. We report a case of percutaneous retrieval of a gunshot bullet from the right ventricle (RV) cavity of a 40-year-old lady. To the best of our knowledge, this is the first case to be reported with a right supraclavicular inlet of the...

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Autores principales: Naeim, Hesham Abdo, Abuelatta, Reda, Sandogji, Hasan, ElRowiny, Ramy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601199/
https://www.ncbi.nlm.nih.gov/pubmed/31449612
http://dx.doi.org/10.1093/ehjcr/ytz059
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author Naeim, Hesham Abdo
Abuelatta, Reda
Sandogji, Hasan
ElRowiny, Ramy
author_facet Naeim, Hesham Abdo
Abuelatta, Reda
Sandogji, Hasan
ElRowiny, Ramy
author_sort Naeim, Hesham Abdo
collection PubMed
description BACKGROUND: Gunshots embolizing to the heart is a rare occurrence. We report a case of percutaneous retrieval of a gunshot bullet from the right ventricle (RV) cavity of a 40-year-old lady. To the best of our knowledge, this is the first case to be reported with a right supraclavicular inlet of the bullet and successful percutaneous retrieval using a snare from the RV cavity. CASE SUMMARY: A 40-year-old female patient was referred to our cardiac centre from a general hospital with a gunshot injury 8 days prior. On arrival, she was haemodynamically stable, there was an inlet wound at the right supraclavicular area. Transthoracic echocardiography revealed the bullet in the RV cavity. Under conscious sedation, right femoral vein access succeeded to retrieve the shot from the RV to the groin. The bullet slipped out and resnared from the right internal iliac vein and came out safely from the right femoral vein through the 24-Fr sheath. The vein was closed using a figure of 8 suture. The patient discharged home after 2 days. DISCUSSION: Bullet emboli to the heart are rare, endovascular retrieval of a bullet from the right ventricular cavity is feasible and relatively safe; however, more research is required. Echocardiography during the procedure is strongly recommended to early detect any complications. Accurate use of available tools such as X-ray, echocardiography, computed tomography, and fluoroscopy is a must for precise diagnosis.
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spelling pubmed-66011992019-07-29 Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature Naeim, Hesham Abdo Abuelatta, Reda Sandogji, Hasan ElRowiny, Ramy Eur Heart J Case Rep Case Reports BACKGROUND: Gunshots embolizing to the heart is a rare occurrence. We report a case of percutaneous retrieval of a gunshot bullet from the right ventricle (RV) cavity of a 40-year-old lady. To the best of our knowledge, this is the first case to be reported with a right supraclavicular inlet of the bullet and successful percutaneous retrieval using a snare from the RV cavity. CASE SUMMARY: A 40-year-old female patient was referred to our cardiac centre from a general hospital with a gunshot injury 8 days prior. On arrival, she was haemodynamically stable, there was an inlet wound at the right supraclavicular area. Transthoracic echocardiography revealed the bullet in the RV cavity. Under conscious sedation, right femoral vein access succeeded to retrieve the shot from the RV to the groin. The bullet slipped out and resnared from the right internal iliac vein and came out safely from the right femoral vein through the 24-Fr sheath. The vein was closed using a figure of 8 suture. The patient discharged home after 2 days. DISCUSSION: Bullet emboli to the heart are rare, endovascular retrieval of a bullet from the right ventricular cavity is feasible and relatively safe; however, more research is required. Echocardiography during the procedure is strongly recommended to early detect any complications. Accurate use of available tools such as X-ray, echocardiography, computed tomography, and fluoroscopy is a must for precise diagnosis. Oxford University Press 2019-04-29 /pmc/articles/PMC6601199/ /pubmed/31449612 http://dx.doi.org/10.1093/ehjcr/ytz059 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Reports
Naeim, Hesham Abdo
Abuelatta, Reda
Sandogji, Hasan
ElRowiny, Ramy
Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
title Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
title_full Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
title_fullStr Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
title_full_unstemmed Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
title_short Percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
title_sort percutaneous retrieval of an embolized gunshot bullet from right ventricle: a case report and review of literature
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601199/
https://www.ncbi.nlm.nih.gov/pubmed/31449612
http://dx.doi.org/10.1093/ehjcr/ytz059
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