Chronic Heart Perforation With 13

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Presentation transcript:

Chronic Heart Perforation With 13 Chronic Heart Perforation With 13.5 cm Long Kirschner Wire Without Pericardial Tamponade: An Unusual Sequelae After Shoulder Fracture Igor Medved, MD, Ognjen Simic, MD, PhD, Marina Bralic, MD, Valter Stemberga, MD, Miljenko Kovacevic, MD, Ante Matana, MD, PhD, Alan Bosnar, MD, PhD The Annals of Thoracic Surgery Volume 81, Issue 5, Pages 1895-1897 (May 2006) DOI: 10.1016/j.athoracsur.2005.06.061 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Postoperative roentgenogram after osteosynthesis of the right humerus with the Kirschner wires (see arrow). (B) Chest roentgenogram revealing a metallic foreign body in the thorax. (Arrow indicates the wire). The Annals of Thoracic Surgery 2006 81, 1895-1897DOI: (10.1016/j.athoracsur.2005.06.061) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Computed tomographic scan showing the wire (see arrow) in the heart. (B) Subcostal two-dimensional echocardiographic image shows the wire (see arrow) tip that appears to cross the right ventricular wall. (AO = aorta; LA = left atrium; RA = right atrium; RV = right ventricle.) The Annals of Thoracic Surgery 2006 81, 1895-1897DOI: (10.1016/j.athoracsur.2005.06.061) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A, B) Autopsy report demonstrates the wire in the cavity of the right atrium, which is embedded in the papillary muscle of the right ventricle, perforating myocardium, and pericardium, ending in the left pleural space. The Annals of Thoracic Surgery 2006 81, 1895-1897DOI: (10.1016/j.athoracsur.2005.06.061) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 The microscopical appearance of the heart. (A) Inflammatory infiltration observed in pericardial layer. (B) Epicardium covered with fibrin deposits. (Hematoxylin and eosin; magnification ×20.) The Annals of Thoracic Surgery 2006 81, 1895-1897DOI: (10.1016/j.athoracsur.2005.06.061) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions