Abstract
Foreign body embolism of heart chambers is most frequently a result of iatrogenic complication. Therefore, while inserting and removing a catheter, all necessary precautions must be taken to avoid such complications as dislocation or rupture of the catheter, which can lead to embolism or perforation of heart chambers and great vessels, resulting in hemopericardium and infectious complications. Early diagnosing of catheter rupture and dislocation is almost impossible, since these patients usually don’t have any specific symptoms. In this report a rare clinical case is described: endovascular removal of foreign body from right chambers of the heart (right atrium and ventricle) in a cancer patient. In 2015 a port system “Celsite” have been implanted to this patient (with right subclavian access) for injection of chemotherapeutic drugs. Endovascular surgery is the safest and most effective way of removing foreign bodies from heart chambers and great vessels. Efficiency, as we said, is more than 90% and possible risk of intraoperative and postoperative complications is very low. This is especially important in patients who are undergoing a long-term chemotherapy due to malignant cancer.
References
- Lindman B.R., Dweck M.R., Lancellotti P., Généreux P., Piérard L.A., O'Gara P.T., Bonow R.O. Management of asymptomatic severe aortic stenosis: Evolving concepts in timing of valve replacement. JACC Cardiovasc. Imaging. 2020; 13 (2, Pt. 1): 481–93. DOI: 10.1016/j.jcmg. 2019.01.036
- Bockeria L.A., Gazal Belal. Combined pathology of the aortic valve with ischemic heart disease: the current state of the problem. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2009; 10 (4): 22–33 (in Russ.).
- Bockeria L.A., Milievskaya E.B., Kudzoeva Z.F., Prianishnikov V.V. Cardiovascular surgery – 2017. Diseases and congenital anomalies of the circulatory system. Moscow; 2018 (in Russ.).
- Clinical recommendations 2020. Aortic stenosis.
- Thaden J.J., Nkomo V.T., Enriquez-Sarano M. The global burden of aortic stenosis. Prog. Cardiovasc. Dis. 2014; 56 (6): 565–71.
- Otto C.M., Nishimura R.A., Bonow R.O., Carabello B.A., Erwin J.P. 3rd, Gentile F. et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021; 143: e72–e227. DOI: 10.1161/CIR.0000000000000923
- Barry A.R., Wang E.H.Z. Therapeutic controversies in the medical management of valvular heart disease. Ann. Pharmacother. 2021; 55 (11): 1379–85. DOI: 10.1177/1060028021992329
- Baumgartner H., Falk V., Bax J.J., De Bonis M., Hamm Ch., Holm P.J. et al. ESC Scientific Document Group, 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur. Heart J. 2017; 38 (Issue 36): 2739–91. DOI: 10.1093/eurheartj/ehx391
- Unger P., Pibarot P., Tribouilloy C., Lancellotti P., Maisano F., Iung B., Piérard L.; European Society of Cardiology Council on Valvular Heart Disease. Multiple and mixed valvular heart diseases. Circ. Cardiovasc. Imaging. 2018; 11 (8): e007862. DOI: 10.1161/CIRCIMAGING.118.007862
- Grimard B.H., Safford R.E., Burns E.L. Aortic stenosis: Diagnosis and treatment. Am. Fam. Physician. 2016; 93 (5): 371–8.
- Kanwar A., Thaden J.J., Nkomo V.T. Management of patients with aortic valve stenosis. Mayo Clin Proc. 2018; 93 (4): 488–508. DOI: 10.1016/j.mayocp.2018.01.020
- Bermejo J., Postigo A., Baumgartner H. The year in cardiovascular medicine 2020: valvular heart disease. Eur. Heart J. 2021; 42 (6): 647–56. DOI: 10.1093/eurheartj/ehaa1060
- Sundt T.M., Jneid H. Guideline update on indications for transcatheter aortic valve implantation based on the 2020 American College of Cardiology/American Heart Association Guidelines for Management of Valvular Heart Disease. JAMA Cardiol. Published online July 21, 2021. DOI: 10.1001/jamacardio.2021.2534
- Agarwal S., Garg A., Parashar A., Svensson L.G., Tuzcu E.M., Navia J.L. et al. In-hospital mortality and stroke after surgical aortic valve replacement: A nationwide perspective. J. Thorac. Cardiovasc. Surg. 2015; 150 (3): 571–8.e8. DOI: 10.1016/j.jtcvs.2015.05.068. Epub 2015 Jun 5.
- Burlacu A., Covic A., Cinteza M., Lupu P.M., Deac R., Tinica G. Exploring current evidence on the past, the present, and the future of the heart team: A narrative review. Cardiovasc. Ther. 2020; 2020: 9241081. DOI: 10.1155/2020/9241081
- Adams H.S.L., Ashokkumar S., Newcomb A., MacIsaac A.I., Whitbourn R.J., Palmer S. Contemporary review of severe aortic stenosis. Intern. Med. J. 2019; 49 (3): 297–305. DOI: 10.1111/imj.14071
- Ambler G., Omar R.Z., Royston P., Kinsman R., Keogh B.E., Taylor K.M. Generic, simple risk stratification model for heart valve surgery. Circulation. 2005; 112 (2): 224–31. DOI: 10.1161/CIRCULATIONAHA.104.515049. Epub 2005 Jul 5.
- Chislova A.P., Kupryashov A.A., Kovalev D.V., Mokrinskaya L.Yu., Astrakhantseva T.O., Rybka M.M. Influence of hemodilution on the development of complications in the early postoperative period in patients with cyanotic congenital heart diseases operated with cardiopulmonary bypass. Clinical Physiology of Circulation. 2018; 15 (3): 198–206 (in Russ.). DOI: 10.24022/1814-6910-2018- 15-3-198-206
- Yan A.T., Koh M., Chan K.K. et al. Association between cardiovascular risk factors and aortic stenosis: the CAN – HEART Aortic Stenosis Study. J. Am. Coll. Cardiol. 2017; 69 (12): 1523–32.
- Edwards F.H., Peterson E.D., Coombs L.P., DeLong E.R., Jamieson W.R., Shroyer A.L.W., Grover F.L. Prediction of operative mortality after valve replacement surgery. J. Am. Coll. Cardiol. 2001; 37 (3): 885–92. DOI: 10.1016/s0735-1097(00)01202-x
- Shi N., Liu K., Fan Y., Yang L., Zhang S., Li X. et al. The association between obesity and risk of acute kidney injury after cardiac surgery. Front Endocrinol. (Lausanne). 2020; 11: 534294. DOI: 10.3389/fendo.2020.534294
- Shevchenko Yu.L., Matveev S.A., Chechetkin A.V. Cardiac surgical transfusiology. Moscow; 2000 (in Russ.).
- Van Straten A.H., Külcü K., Özdemir H.I., Elenbaas T.W., Soliman Hamad M.A. Preoperative hemoglobin level as a predictor of mortality after aortic valve replacement. J. Cardiothorac. Vasc. Anesth. 2013; 27 (4): 716–22. DOI: 10.1053/j.jvca.2012.12.021. Epub 2013 May 22.
- Cladellas M., Bruguera J., Comín J., Vila J., de Jaime E., Martí J., Gomez M. Is pre-operative anaemia a risk marker for in-hospital mortality and morbidity after valve replacement? Eur. Heart J. 2006; 27 (9): 1093–9. DOI: 10.1093/eurheartj/ehi830
- Smirnov A.V., Shilov E.M., Dobronravov V.A., Kayukov I.G., Bobkova I.N., Shvetsov M.Yu. et al. National guidelines. Chronic kidney disease: basic principles of screening, diagnosis, prevention and treatment approaches. Nephrology (Saint-Petersburg). 2012; 16 (1): 89–115 (in Russ.). DOI: 10.24884/1561-6274-2012-16-1-89-115
- Tinica G., Brinza C., Covic A., Popa I.V., Tarus A., Bacusca A.E., Burlacu A. Determinants of acute kidney injury after cardiac surgery: a systematic review. Rev. Cardiovasc. Med. 2020; 21 (4): 601–10. DOI: 10.31083/j.rcm.2020.04.206
About the authors
- Shamil’ M. Abdulkerimov, Cardiovascular Surgeon
- Gyulsuna A. Yurkulieva, Cardiologist
- Gulamzhan M. Dadabaev, Cand. Med. Sci., Researcher, Cardiovascular Surgeon;
ORCID
- Gul’mira A. Arsibieva, Resident
- Leo A. Bockeria, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, President; ORCID
- Ol’ga L. Bockeria, Dr. Med. Sci., Professor, Correspondent Member of Russian Academy of Sciences; ORCID