Catheter embolization into the heart (Hebrew)

A polyethylene catheter embolized into the right atrium of a 27 yr old pregnant woman. Eight hours later she was operated on and the catheter was successfully removed. In 120 cases of catheter embolism in the literature the catheter fragments were located in the extremities in 41, and 36 of them underwent operation. Of three cases in which the catheter was located in the inferior vena cava, none was operated on, but one patient died from massive pulmonary embolism associated with the catheter. Of 7 cases in whom the catheter fragment was found in the superior vena cava, 3 were operated on and 2 died of complications of catheter embolism. In 37 cases the catheter fragments were located in the right atrium or ventricle. 22 of them were operated on and two died after the operation. In the remaining 15 patients in whom the catheter was not removed there were nine deaths (60%). In 22 patients the catheter was found in the pulmonary artery and in 14 of them it was removed with no fatalities. There were 2 deaths among the 8 patients in whom the catheter was not removed. In one case the catheter was found in the pulmonary artery after paradoxical embolism through an open foramen ovale. In 10 patients there were insufficient details about the location of catheters or treatment. Measures designed to prevent the breakage and embolization of polyethylene catheters and to facilitate their retrieval in case of loss are discussed. Catheter emboli anywhere in the venous system should be located and removed immediately.