Removal of sewing needles from interventricular septum under the guidance of multiple imaging modalities

Background: Penetration of the interventricular septum (IVS) by a sharp foreign body is a rare and potentially life-threatening event. Methods: We present the case of a 43-year-old female who had thrust four embroidery needles into her left chest wall while experiencing hallucinations after using an illegal drug. One needle had penetrated the heart and was embedded in the IVS, as confirmed by intraoperative transesophageal echocardiography (TEE), and one needle had lodged in the left chest wall. Results: The sewing needles penetrating the IVS and chest wall were successfully removed under the guidance of TEE and a cardiopulmonary bypass without cross-clamping the aorta or opening the heart. Conclusion: The sewing needles embedded in the IVS and left chest wall were successfully removed with the aid of multiple imaging modalities.