Extravascular migration of a guide wire with perforation of the heart eight months after percutaneous coronary intervention: consequence of a conservative approach.

Impingement of a guide wire is not unusual during complex percutaneous coronary intervention procedures. It is mostly retrieved by endovascular procedures. If not possible, conservative therapy is frequently the next option, leaving the guide wire in place. This case describes the consequence of such an approach 9 months after initial percutaneous coronary intervention. The guide wire migrated through the abdominal cavity and finally perforated the heart. We therefore defend a more aggressive approach if a guide wire is locked in or lost. Surgical retrieval seems to be the best choice. Fixation of the guide wire with a stent is an acceptable alternative in high-risk patients.