Multimodal imaging of an embolized vena cava filter strut causing right ventricular perforation
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KeywordsInferior Vena Cava Right Ventricle Pericardial Effusion Motor Vehicle Accident Inferior Vena Cava Filter
A 45-yr-old male presented with chest pain. Cardiac troponins were negative and the electrocardiogram revealed non-specific ST changes in multiple leads. The patient’s medical history was significant for a prior motor vehicle accident with multiple orthopedic injuries and prophylactic placement of an inferior vena cava (IVC) filter given the risk of deep venous thrombosis.
Fracture of an IVC filter strut results from metal fatigue and is extremely rare. The clinical presentation varies from asymptomatic to sudden death due to malignant arrhythmias or tamponade.
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VIDEO Side-by-side images from intraoperative transesophageal echocardiography. The video orientation is similar to that of the Figure (panel C). A linear echodense structure is seen spanning the right ventricle between the interventricular septum and the right ventricular free wall. A moderate-sized pericardial effusion is observed and is largest between the posterior heart and liver. The left ventricle is hyperdynamic and underfilled. (MPG 984 kb)