Author + information
- Sivasankaran Sivasubramanian, MD, DM∗,
- Shunmuga Sundaram Ponnusamy, MD, DM∗,
- Kapilamoorthy Tirur Raman, MD† and
- Vivek V. Pillai, MS, MCh‡
- ∗Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thriuvananthapuram, Kerala, India
- †Department of Imaging Science and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thriuvananthapuram, Kerala, India
- ‡Department of Cardiovascular and Thoracic surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thriuvananthapuram, Kerala, India
A 22-year-old man was evaluated for cardiac failure of 3 weeks duration. Chest x-ray (A) showed a shadow of a wire (thin arrow) in the mediastinum, confirmed by fluoroscopy and computed tomography scan (C and D, Online Video 1). He had wiring for the right clavicle fracture 6 months prior (thin dotted arrow) (B). The long wire was removed after 2 months.
Transthoracic echocardiogram (E to H, Online Video 2), showed features of severe acute aortic regurgitation. A foreign body was imaged across the aortic valve (open arrow) (H), which was successfully (I to K) removed with aortic valve replacement.
Kirschner wires, used to join fractured bones, are known to migrate through soft tissues and vascular spaces as late as 25 years after implantation. This presentation illustrates a life threatening complication caused by mediastinal migration of the Kirschner wire and Echo-Doppler features of acute aortic regurgitation. Asc Ao = ascending aorta; LVOT = left ventricular outflow tract.
- Received March 24, 2013.
- Accepted April 16, 2013.