Videothoracoscopic approach to the extraction of a cardiac retainer missile

• Main Authors: Carlos Andres Muñoz, Jairo González Quitian, Alberto García, Carlos Alberto Ordoñez, Víctor Rafael Buchelli
• Format: Article
• Language: English
• Published: Elsevier 2021-06-01
• Series: Trauma Case Reports
• Subjects: Cardiac injury; Cardiac missiles; Bullet embolus; Pericardium injury
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352644021000947

The presence of foreign bodies (FB) retained in the heart or pericardium secondary to penetrating trauma in stable patients is a very rare event and its management is controversial. We present the case of a 19-year-old patient who was admitted to our trauma center hemodynamically stable because of two gunshot wounds in the lumbar region. A chest x-ray (CXR) revealed a blurred foreign body over the right heart chamber, thoracoabdominal computed tomography (CT) scan showed a free projectile over the left atrial wall, and transesophageal echocardiogram (TEE) showed a hyperrefringent pericardial sac image near the right ventricle. Finally, the patient went to surgery where a missile was removed from the pericardial sac by video-assisted thoracoscopic surgery (VATS).