Case Report:
A 3 years old child of average body mass index and normal developmental milestones with history of falling down on his abdomen was referred to paediatric cardiology department with recurrent chest pain for 3 months that was not managed by seeking many medical experts. X-ray revealed nothing and he was treated by simple analgesia. Echocardiography showed a thorn within the left ventricle that’s penetrating from the apex posteriorly covered by big clot anteriorly that measures (15cm × 11cm) and was diagnosed as foreign body that was complicated by infective endocarditis (Figure 1 ). The patients was put on the medical treatment of infective endocarditis according to the international regimen for 2 to 3 weeks, followed by inflammatory markers follow-up and then he was shifted to operation room to undergo median sternotomy which showed normal pericardium apart from adhesions between chest and diaphragm. The patient was put on by pass after we arrest the heart; adhesions were removed completely then they revealed the definitive body (Figure 2 ), foreign body reaction and a whole of a big slider thorn come out. We went into trans-atrial approach through left atrium and then through mitral valve with organized thrombus, we washed with antibiotic solution, we checked that’s mitral valve is normal then we closed. Tricuspid valve was tested and was found to be normal so right atrium was closed. We debride the place of foreign body entry, then we closed using pericardium strips of two layers warmed and separated. Haemostasis was secured and the chest was closed with two chest tubes. Patient was sent to paediatric ICU under cover of broad spectrum antibiotics, antifungal and analgesia on need. Child was extubated successfully on the next day and was followed-up for 1 week clinically, with laboratory markers and then was sent home after Echo was done on the day of discharged which showed completely normal heart. The patient was told to be seen on refer clinic after 1 month of discharge.