CASE 42: Fractured IVC Filter With Cardiac Embolization

Detailed view of a CXR obtained during the hospitalization of a kidney transplant recipient with a history of recurrent DVTs and pulmonary embolus despite anticoagulation who had an IVC filter (yellow arrow) placed 6 years prior to the current hospitalization for re-transplantation. Two metal filaments (a vertical one shown with green arrows and a horizontal one marked with orange arrows) can be see within the heart.

Follow up CT scan demonstrated two metal fragments (a vertical one marked with a green arrow and a horizontal one shown with an orange arrow) embedded within the wall of the right ventricle.

Follow up CT scan demonstrated two metal fragments (a vertical one marked with a green arrow and a horizontal one shown with an orange arrow) embedded within the wall of the right ventricle.

CT images show a decreasing number of legs of the IVC filter as the sections move distally. Note as well that the filter is in a retro-hepatic position, proximal to the renal veins.

A coronal view shows that another leg of the IVC filter (blue arrow) has migrated into the left gonadal vein.

Inspection of archived images revealed a chest x-ray obtained 3 years prior to the current evaluation with both metal fragments (green and orange arrows) in an identical location. Note also the IVC filter (yellow arrow).