Retained left atrial catheter: An unusual cardiac source of embolism identified by transesophageal echocardiography

Embolic events have become a major indication for transesophageal echocardiography. We report three patients with cerebrovascular accident who were discovered to have retained left atrial catheter as a cardiac source of embolism. These radiolucent catheters, placed during previous cardiac surgery, were used for perioperative left atrial monitoring. Fracture of the catheter occurred during percutaneous removal after surgery. Subsequent identification was established by transesophageal echocardiography, which demonstrated a characteristic appearance of the catheter remnant within the left atrium. All patients underwent reoperation to remove the retained catheter and have had no recurrent embolic events. Although uncommon, retained catheter in the left atrium is an important potential source of systemic embolism. The diagnosis can be easily made with transesophageal echocardiography and should prompt surgical extraction of the catheter.