Skip to main content
SpringerLink
Log in

Removal of broken balloon mitral valvotomy coiled guidewire from giant left atrium using indigenous snare

  • Case Report
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

Balloon mitral valvotomy (BMV) is a safe and effective therapy for rheumatic mitral stenosis. During the procedure, the coiled portion of 0.025 in. stainless steel BMV guidewire broke off within the giant left atrium (LA). Attempts to retrieve the guidewire with various snares failed as it was moving freely within the voluminous LA. We describe a technique wherein the broken guidewire was retrieved with a snare made of 0.014 in. percutaneous transluminal coronary angioplasty guidewire. The mechanism and prevention of this complication and management options are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Palacios I, Block PC, Brandi S, Blanco P, Casal H, Pulido JI, Munoz S, D’Empaire G, Ortega MA, Jacobs M, et al. Percutaneous balloon valvotomy for patients with severe mitral stenosis. Circulation. 1987;75(4):778–84.

    CAS  PubMed  Google Scholar 

  2. Manjunath CN, Srinivasa KH, Patil CB, Venkatesh HV, Bhoopal TS, Dhanalakshmi C. Balloon mitral valvuloplasty: our experience with a modified technique of crossing the mitral valve in difficult cases. Cathet Cardiovasc Diagn. 1998;44(1):23–6.

    Article  CAS  PubMed  Google Scholar 

  3. Complications and mortality of percutaneous balloon mitral commissurotomy. A report from the National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry. Circulation. 1992;85(6):2014–24.

    Google Scholar 

  4. Inoue K, Owaki T, Nakamura T, Kitamura F, Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984;87:394–402.

    CAS  PubMed  Google Scholar 

  5. Thomas J, Sinclair-Smith B, Bloomfield D, Davachi A. Non-surgical retrieval of a broken segment of steel spring guide from the right atrium and the inferior vena cava. Circulation. 1964;30:106–8.

    CAS  PubMed  Google Scholar 

  6. Koseoglu K, Parildar M, Oran I, Memis A. Retrieval of intravascular foreign bodies with goose neck snare. Eur J Radiol. 2004;49(3):281–5.

    Article  PubMed  Google Scholar 

  7. Massumi RA, Ross AM. A traumatic nonsurgical technique for removal of broken catheters from cardiac cavities. N Engl J Med. 1967;277(4):195–6.

    Article  CAS  PubMed  Google Scholar 

  8. Rossi P. “Hook catheter”, technique for transfemoral removal of foreign body from the right side of the heart. Am J Roentgenol Radium Ther Nucl Med. 1970;109(01):101–6.

    CAS  PubMed  Google Scholar 

  9. Grabenwoeger F, Dock W, Pinterits F, Apple W. Fixed intravascular foreign bodies: a new method for removal. Radiology. 1988;167(2):555–6.

    CAS  PubMed  Google Scholar 

  10. Martins EC, Faria GB. Percutaneous retrieval of intracardiac foreign body with a novel technique. Arq Bras Cardiol. 2007;88(6):e179–81.

    Article  PubMed  Google Scholar 

  11. Massin M, Lombet J, Rigo J. Percutaneous retrieval of broken silastic catheter from the left atrium in a critically Ill premature infant. Cathet Cardiovasc Diagn. 1997;42(4):409–11.

    Article  CAS  PubMed  Google Scholar 

  12. Ruiz CE, Nystrom GA, Butt AI, Zhang HP. Percutaneous retrieval of a broken umbilical catheter from left atrium in a premature newborn. Cathet Cardiovasc Diagn. 1995;36(3):265–8.

    Article  CAS  PubMed  Google Scholar 

  13. Casserly IP, Goldstein JA, Rogers JH, Lasala JM. Paradoxical embolization of a fractured guidewire: successful retrieval from left atrium using a snare device. Catheter Cardiovasc Interv. 2002;57(1):34–8.

    Article  PubMed  Google Scholar 

  14. Ramondo AB, Favero L, Chioin R. Percutaneous retrieval of a broken catheter from the left atrium in an adult. J Interv Cardiol. 2002;15(5):417–9.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jaya Nagar 9th Block, BG Road, Bangalore, 560069, India

    Ravindranath Khandenahally Shankarappa, Arunkumar Panneerselvam, Ramesh Dwarakaprasad, Mohan Honnayya Nayak & Manjunath Cholenahally Nanjappa

Authors
  1. Ravindranath Khandenahally Shankarappa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arunkumar Panneerselvam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ramesh Dwarakaprasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohan Honnayya Nayak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Manjunath Cholenahally Nanjappa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arunkumar Panneerselvam.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 1:

The severed 0.025 in. coiled balloon mitral valvotomy guidewire seen revolving freely within the giant left atrium (AVI 4351 kb)

Video 2:

The loop of the snare being manipulated in various planes in the left atrium inan attempt to capture the detached coiled balloon mitral valvotomy guidewire (AVI 2986 kb)

Video 3:

The captured guidewire being firmly anchored by reducing the loop of the snareto the minimum possible size and by withdrawing the multipurpose catheter so that it lieswithin the Mullin’s sheath. The entire snare unit is removed en bloc (AVI 3892 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shankarappa, R.K., Panneerselvam, A., Dwarakaprasad, R. et al. Removal of broken balloon mitral valvotomy coiled guidewire from giant left atrium using indigenous snare. Cardiovasc Interv and Ther 26, 60–63 (2011). https://doi.org/10.1007/s12928-010-0025-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-010-0025-0

Keywords

Search

Navigation