After median sternotomy and pericardiotomy surgeons could observe an externalized guidewire on the lower wall, on the way to the PLA that was partially removed through the inferior heart wall (total extension of 17 cm) (figure 3).
A B
Figure 3- Manual extraction of guide wire after pericardiotomy (A). Extenson of extracted guidewire (B).
Concurrently during intraoperative transesophageal ecocardiography it was observed a hyperechogenic filamental structure along the ascending aorta (figure 4 ).