Management of the high-risk patient should be individualized based on an assessment of the operative risk and the morbidity and mortality associated with leaving the material in situ. If the nonoperative approach is chosen, steps should be taken to reduce potential infectious and thrombotic complications. When catheter breakage occurs, immediate attempts at extraction by venous cutdown should be made. If these attempts are unsuccessful, the patient should be monitored for dysrhythmia while the fragment is located. Once the embolus is located, percutaneous retrieval with extraction catheters should be attempted.
Operative removal is the last option for patients with emboli in high-risk locations.
If these methods fail, then bacterial and thrombotic prophylaxis should be instituted and maintained for at least 2 years. Hickman catheter separation. Percutaneous retrieval of foreign bodies from the cardiovascular system. Techniques for nonsurgical retrieval of iatrogenic foreign bodies from the heart. Catheter emboli to the heart and pulmonary artery.