Document Detail


Intravascular migration of a broken cerclage wire into the left heart.
MedLine Citation:
PMID:  25275983     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
This article describes a patient in whom a broken cerclage wire migrated from the left hip into the left ventricle. A 71-year-old woman was admitted to the authors' hospital for preoperative examination before femoral hernia repair. Chest radiograph showed a metallic wire in the left ventricle. Twenty-four years earlier, she had a revision arthroplasty. During revision surgery, fragments of the osteotomy were fixed to the femur with multiple cerclage wires. During the past 5 years, radiographic follow-up showed progressive multiple ruptures of cerclage wires. The cerclage wiring was not removed because the patient had no related clinical symptoms. Radiograph of the left hip showed a well-fixed cemented acetabular ring and an uncemented femoral stem with a healed trochanteric osteotomy. All cerclage wires were broken into multiple parts, and it was very difficult to determine which part had migrated into the heart. Thoracic computed tomography scan showed wire that had migrated into the anterior left ventricular myocardial wall at the atrioventricular level. The patient had no clinical symptoms. Electrocardiogram showed a normal sinus rhythm and right bundle branch block. Because of the high risk of surgical left ventriculotomy associated with searching for wire that had migrated into the myocardial wall, patient monitoring was planned. Definitive management of this complication constitutes a dilemma. Although this complication is highly unusual, the possibility of intracardiac migration of broken wire should be considered when deciding on prophylactic surgical removal of hardware after fracture or osteotomy healing.
Authors:
Francesco Leonardi; Fabrizio Rivera
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  37     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-10-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e932-5     Citation Subset:  IM    
Copyright Information:
Copyright 2014, SLACK Incorporated.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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