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Zhenghua Xiao, Jun Gu, Chaoyi Qin, Eryong Zhang, Bullet incarcerated in aortic root, European Heart Journal, Volume 37, Issue 8, 21 February 2016, Page 659, https://doi.org/10.1093/eurheartj/ehv668
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A 47-year-old man was admitted to our emergency department with thoracic gunshot after 11 h. He complained no dizzy, headache, or short of breath. Physical examinations showed an approximate 0.5 cm ballistic hole at the 4th intercostal space just left to the sternum. Normal heart and lung auscultations were examined. Contrast-enhanced computed tomography (CT) scan showed a high-dense shallow on the root of the aorta (Panels A and B, arrows). Surprisingly, only a little left hydrothorax and no pericardial effusion were demonstrated. Transoesophageal echography (TEE) showed an approximate 3 mm high-echo incarceration in the wall of the aortic non-coronary sinus, with no evidence of aortic cusps movement dysfunction and aortic valve regurgitation (Panels C and D, arrows, Supplementary material online, Videos S1 and S2). The patient refused to perform surgery due to the present condition and stable haemodynamic. Transoesophageal echography showed no difference in 3-month follow-up. Since the strict gun management law in China and no complications presented, this is a really interesting and rare case.