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Removal of Migrated Venous Iliac Stent and Tricuspid Repair
Philip M. Allen1, Rami Bikdash1, Piotr Sobieszczyk2, George Tolis1, Sary Aranki1, Ashraf Sabe1, Borami Shin1
1Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States, 2Interventional Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, United States
Objective:
While rare, embolization or migration to the heart is but dangerous complication of peripheral venous stent placement. We are presenting our experience with a patient who had an incidentally found migrated venous iliac stent placed for May-Thurner syndrome ~5.5 years prior to presentation.
Methods:
We attempted endovascular removal first but patient ultimately underwent open removal with tricuspid commisuroplasty given the incorporated nature of the stent, both into the endocardium of the right atrium as well as the tricuspid valve.
Results:
The patient underwent uncomplicated stent removal and tricuspid valve repair. Post-operative echo showed trace tricuspid regurgitation and the patient was discharged on POD5.
Conclusions:
The video depicts our institution's management of an embolized venous iliac stent to the right atrium and tricuspid valve and highlights the dense incorporation of endocardial scar tissue into the stent as well as the meticulous dissection necessary to preserve tricuspid valve tissue for following repair.
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