Article Text

Download PDFPDF
Cardiac arrest resulting from an unidentified foreign object, later identified as a balloon cover, within the left anterior descending coronary artery
  1. Pascal Christiaan Jan Visser1,
  2. Maarten A Vink1,
  3. Mark S Patterson1,
  4. Aria Yazdanbakhsh2,
  5. Fatih Arlan3 and
  6. Remko S Kuipers1
  1. 1Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
  2. 2Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Noord-Holland, Netherlands
  3. 3Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, Utrecht, Netherlands
  1. Correspondence to Dr Pascal Christiaan Jan Visser; p.c.j.visser{at}


A 31-year-old man with a history of hypertrophic cardiomyopathy and alcohol septal ablation one week before was presented after an out of hospital cardiac arrest in the setting of an anterior wall ST-elevation myocardial infarction. Immediate coronary angiography showed an unidentified foreign object within the left anterior descending coronary artery (LAD), later identified as the cover of a balloon that had been unintentionally inserted and abandoned within the LAD during the alcohol septum ablation one week earlier. Intracoronary imaging confirmed the presence of endothelial damage and thrombus formation within the LAD explaining acute myocardial infarction. The patient was treated by surgical retrieval of the balloon cover, extended septal myectomy and coronary artery bypass grafting (CABG) of the LAD. This case is both an example of unintentional neglect of unexpected objects, and the importance of multimodality imaging and multidisciplinary teamwork to get to a correct diagnosis and treatment.

  • Interventional cardiology
  • Gastrointestinal surgery

Statistics from


  • Contributors PCJV is cardiologist-in-training who wrote the article and was the the doctor at the ER at time of admission. RSK was his outpatient cardiologist and contributed to supervising the whole writing process. MSP and MAV are both interventional cardiologists who have performed the coronary angiography, optical coherence tomography and intravascular ultrasound. MSP, MAV en AY have led the multidisciplinary discussion for his final treatment. Finally FA supervised the writing process.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.