Patient L.T.T. (48 years old, Lam Dong province) was treated for rectal cancer four years ago. During chemotherapy, the patient was given a subcutaneous vein injection chamber through the vein under the right puncture, to directly take the medicine into the central vein system to truyen the chemicals into the aorta.
After completing the treatment regimen including chemotherapy, radiotherapy and surgery, due to not being specifically advised on removing the device, the patient still kept the chemical IV tube in the body for nearly three years even though it was no longer used.
During a screening visit to a private medical facility, the patient was prescribed a chest CT scan with an injection of optic vaccine. The results showed an image of a foreign object in the heart, crossing the position of the two lung arteries. At risk of complications, the patient was advised to have foreign object removed intervention and returned to a public hospital, where he was treated for rectal cancer, for further examination.
Here, the chest X-ray results determined that the chemical port bus had broken. One section is still under the skin, while the other section has moved with blood flow into the heart and is stuck in the pulmonary artery. The patient was given a skin canal to remove the remaining tube under the skin; the section that floated into the heart was transferred to Military Hospital 175 for further intensive intervention.
At Military Hospital 175, the team of the Cardiovascular Intervention Department assessed that this was not a technically complicated case. However, the special thing about this case is that the foreign object has moved very deeply, located near the division of the pulmonary artery branches, an extremely rare clinical location.
The team decided to choose a less invasive intervention method, removing the foreign object through the thigh vein, to avoid chest surgery or heart surgery, which has many potential risks and requires a long recovery time. With precise intervention techniques, the broken chemical transmission pipe was safely removed.
Master, Doctor Hoang Hai Anh - Department of Cardiovascular Intervention, Military Hospital 175, who directly participated in the case handling, said: "This is not an overly complicated intervention, but the rare thing is that the foreign object has moved very deeply. The location is close to the division of the pulmonary artery branches, making access difficult. If allowed to continue, the patient is at risk of pulmonary embolism or arrhythmia, which is life-threatening. This is also the first time the hospital has received and treated such a foreign object located deep in the heart.
Thanks to the application of less invasive techniques, the intervention went smoothly. The patient was alert immediately after the procedure, recovered well and was discharged after a short period of monitoring.
According to Master, Doctor Hoang Hai Anh, foreign objects falling into the pulmonary artery are a particularly dangerous condition. If the foreign object continues to move deeply, the patient may face acute respiratory failure, pulmonary embolism or serious hemorrhagic disorders. In the long term, foreign objects can also cause pneumonia, pulmonary embolism, pulmonary necrosis, sepsis, increase pressure on the right heart, leading to chronic heart failure, even sudden death if not detected and treated promptly.
