Foreign body located intraoperatively using transesophageal echocardiography

摘要

A 30-YEAR-OLD MAN was admitted from an outside hospital with a history of deep venous thromboses, pulmonary emboli while anticoagulated, protein S deficiency, and pulmonary hypertension for the management of chronic thromboembolic pulmonary hypertension. An inferior vena cava (IVC) filter had been placed before the patient was transferred to the authors' institution. An abdominal radiograph was obtained as part of the preoperative evaluation before pulmonary thromboendarterectomy (Fig 1). The patient was taken to the operating room where transesophageal echocar-diography was performed after anesthetic induction and endo-tracheal intubation (Figs 2 and 3). What is the diagnosis?