FOREIGN BODY RETRIEVAL FROM THE RIGHT ATRIUM WITH A LOCALLY-MADE LOOP SNARE

Abstract

The presence of ‘foreign bodies’ inside the heart chambers poses a risk of potentially life-threatening complications, and immediate removal is always advised regardless of the presence or absence of symptoms and the duration of retention. The percutaneous method of extraction is currently advocated, but the low availability and high cost of extraction devices in developing countries make the consideration of surgical intervention and conservative management practice alternatives with higher risks. There are existing reports of the use of locally made loop snares to extract ‘foreign bodies’ from the heart chambers, particularly in India, but no such reported case in Nigeria. This is a case of a 52-year-old Nigerian female with right breast cancer who was receiving her chemotherapeutic medications through a venous access port (chemoport). She suffered a catheter fracture with the migration of the dislodged portion to her right atrium. She presented for extraction, and due to the unavailability of commercial extraction devices, a loop snare was constructed from an angiographic guide-wire by folding the guide-wired into two and passing the looped end through a guide catheter. The loop was then used to extract the fractured catheter from the right atrium without complications. Percutaneous extraction of intra-cardiac foreign bodies is safer and should be attempted despite the unavailability of standard extraction devices. This is the first case to be reported of such a procedure done successfully in Nigeria, and secondly, it also buttresses the fact that percutaneous extraction of intra-cardiac foreign bodies with devised materials can equally be successful.