N T Liu, MD, R C Gilkeson, MD, A H Markowitz, MD, C Schroeder, MD PhD. Case Medical Center, Cleveland, OHio
Objective: To demonstrate a minimally invasive thoracoscopic approach (VATS) for removal of a retained pericardial suture needle after standard CABG surgery.
Methods: A 46 year old male presented with unstable angina in November of 2009. His workup demonstrated significant coronary artery disease for which he underwent a 6 vessel CABG, including dissection into the left chest for preparation of the LIMA. At seven post operative weeks, a chest x-ray demonstrated a foreign body (suture needle) present in the cardiac silhouette. Further CT scan imaging demonstrated the suture needle to be localized in the left inferior-posterior pericardium. The patient underwent a left VATS exploration for removal of the foreign body.
Results: The pericardial suture needle was successfully retrieved using a thoracosopic approach. The chest tube was removed on the first post operative day and the patient was discharged to home on the second post operative day. The patient’s post operative course and recovery were uneventful.
Conclusions: A minimally invasive approach can be undertaken for the removal of a foreign body even after prior open chest surgery, avoiding the associated morbidity of a repeat sternotomy.
Program Number: V039