PERVENOUS RETRIEVAL OF EMBOLIZED CATHETERS FROM THE RIGHT HEART AND PULMONARY-ARTERIES

Successful removal of embolized or retained catheter fragments from the right heart was achieved in two out of four patients using pervenous catheter techniques. For the first time a fragment, radiolucent on image intensification, was retrieved from the right pulmonary artery using a wire snare. In a second case a hook-loop was made in the right ventricle with a Judkins left femoral coronary angiographic catheter, which has advantages over previously described hooking devices, to withdraw a fragment to the iliac vein for subsequent snaring. Failure of retrieval occurred only in specially difficult circumstances; when a catheter embolized to the pulmonary artery of a Tetralogy of Fallot, and when in spite of successful ensnarement, a fractured electrode was firmly adherent to the right ventricular apex. Successful pervenous retrieval may require a combination of techniques which move or dislodge, such as a hook or balloon combined with those which ensnare, such as a wire loop or bioptome. Using such techniques, with minimal additions to standard equipment, retrieval procedures can be offered as a routine cardiac catheterization service with a high rate of success. © 1979.