A girl with 'six needles' in the heart

Removal of sewing needles from interventricular septum under the guidance of multiple imaging modalities

BACKGROUND

Penetration of the interventricular septum (IVS) by a sharp foreign body is a rare and potentially life-threatening event.

METHODS

We present the case of a 43-year-old female who had thrust four embroidery needles into her left chest wall while experiencing hallucinations after using an illegal drug. One needle had penetrated the heart and was embedded in the IVS, as confirmed by intraoperative transesophageal echocardiography (TEE), and one needle had lodged in the left chest wall.

RESULTS

The sewing needles penetrating the IVS and chest wall were successfully removed under the guidance of TEE and a cardiopulmonary bypass without cross-clamping the aorta or opening the heart.

CONCLUSION

The sewing needles embedded in the IVS and left chest wall were successfully removed with the aid of multiple imaging modalities.

An Unusual Presentation of a Cardiac Foreign Body in a Pediatric Patient

Cardiac foreign bodies (FBs) are rare. Their etiology can be attributed to penetrating injuries although they are also often found incidentally. The approach for removal of these FBs is variable and patient dependent. Although there is debate regarding indications for removal, there is a general consensus that symptomatic FBs presenting acutely, as well as asymptomatic FBs posing a greater risk of complication to the patient, should be removed. We present the case of a 14-year-old patient with a cardiac FB and a step-wise approach for removal.