title: Needle Migration to the Heart: An Unusual Association of Hemodialysis and Cardiovascular Morbidity.
abstract: In this report, we present a unique complication of hemodialysis: the hemodialysis access needle was lost into an arteriovenous fistula. The event went unnoticed for several months. The needle eventually migrated into the right ventricle, requiring an operative retrieval. Loss of the needle was likely unrecognized because of the use of a retracting safety cannula that conceals the needle within a sheath after removal. This case highlights a rare and potentially serious complication of hemodialysis access, demonstrates a possible hazard of retracting safety needles, and reviews the management of foreign bodies that have migrated into the heart.
authors.affiliation: From the *Department of Anesthesiology, †Department of Cardiothoracic Surgery, and ‡Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Rafael
authors.initials: R
authors.lastname: Honikman
authors.forename: Joanna
authors.initials: J
authors.lastname: Chikwe
authors.forename: Joji Erik
authors.initials: JE
authors.lastname: Tokita
authors.forename: Alexander J C
authors.initials: AJ
authors.lastname: Mittnacht
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D005548:Foreign-Body Migration / Q000175:diagnosis* / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation