Strutting Through: Migration of Fractured Inferior Vena Cava Filter Through the Right Ventricle

A 68-year-old woman who had a retrievable inferior vena cava filter implanted 10 years ago presented with sudden-onset back pain. Initial computed tomography angiography demonstrated migration of a fractured strut that appeared embedded in the anterior right ventricular free wall without pericardial effusion. Subsequent gated computed tomography of the chest demonstrated further migration of the fragment, which was now penetrating the right ventricular free wall and extending into the pericardial sac. At the time of operative removal through a limited left anterior thoracotomy, the fractured strut had migrated completely through the heart and was positioned posteriorly in the pericardial sac.