A 41-year-old woman was referred to our echocardiography department after intramediastinal migration of a known to be well-tolerated, sharp foreign body, seen on a chest X-ray ( Panels A and B ). According to the patient, the foreign body had penetrated accidentally three months earlier by traumatic effraction due to misuse of a staple gun. Transthoracic echocardiography revealed a transfixial linear echodense image with strong shadowing through the right lateral free wall and the interventricular septum (Panel C; Video 1 ). As migration was giving rise to risk of mitral leaflet injury and perforation of the left atrium, open heart surgery was decided upon. Intraoperatively, complete intracardiac migration was confirmed, only the entrance site being visible at the surface of the heart (Panel D). The foreign body was removed successfully (Panels E and F). There was no postoperative complication.
