Unfortunately the guidewire could not be withdrawn and was stuck. Suspecting the guidewire to be entrapped a 2-dimensional echocardiography (2D Echo) was ordered to look for the position of the guidewire. It was seen that the J-tip guidewire had passed through the tricuspid valve and the tip was entrapped in the right ventricle. Cardiothoracic surgeons were informed about the complication. An emergency medicine consultant manipulated the guidewire under visualization of real-time 2D Echo. The guidewire was rotated anticlockwise with simultaneous soft pulls coinciding with the cardiac cycle. The guidewire was successfully and safely removed under 2D Echo guidance.
Reference:Verma, A., Chitransh, V., Jaiswal, S., Vishen, A., Sheikh, W.R., Haldar, M., Ahuja, R. and Snehy, A. (2020) Guidewire Entrapped in the Right Ventricle: A Rare Complication of Hemodialysis Catheter Insertion. Indian Journal of Critical Care Medicine. 24(1), p.80-81. doi: 10.5005/jp-journals-10071-23334.