Totally Endoscopic Removal of a Sewing Needle Penetrating the Left Ventricle

Background: Intracardiac injuries caused by needles are rare and typically require removal via median sternotomy or limited thoracotomy. We present a case of successful removal using a totally endoscopic minimally invasive cardiac surgery (MICS) approach. Case Presentation: A 57-year-old woman presented with chest discomfort one day after falling and striking her left chest. Chest computed tomography revealed a fractured sewing needle, with one fragment embedded in the left ventricular myocardium and the other in the subcutaneous tissue. The patient remained hemodynamically stable, and removal was performed using a totally endoscopic MICS approach was performed. The intracardiac fragment was removed endoscopically without bleeding. The subcutaneous portion was extracted via a small skin incision. The postoperative course was uneventful, and the patient was discharged on day 5. Conclusion: Totally endoscopic MICS may be a safe and effective option for removing intracardiac foreign bodies in carefully selected patients.