PMC8728862_01
Posteroanterior (A) and Lateral (B) and chest radiography views show a sewing needle in the lung cavity and the mid-mediastinum.
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F1
One end of the needle was tangent to the lateral wall of the RV, and the other end was embedded into the lung tissue and moving with each heartbeat (Figures 1 & 2).
Transthoracic echocardiography views (A & B) show a hyper-refractile linear structure (arrows) tangent to the right ventricular wall, together with its acoustic shadow (arrowhead).
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F2
One end of the needle was tangent to the lateral wall of the RV, and the other end was embedded into the lung tissue and moving with each heartbeat (Figures 1 & 2).
Computed tomography scans show the needle (arrow) in the lower front part of the chest (A & B). The entry point of the needle is from the fat area around the pericardium tangent to the diaphragm. A small bubble of air is seen in the anterior part of the pericardium near the right ventricle in the upper part of the needle (arrowhead) (B). Coronal (C) and Sagittal (D) views show that the needle pathway is very close to the pericardium (arrows).
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F3
TTE, a chest computed tomography (CT) scan showed the needle in the RV inside the pericardium. The difference in the location of the needle in the scan relative to that in echocardiography suggested the migration of the needle into the heart wall (Figure 3). 
The image shows the sewing needle, about 3.5 cm in length.
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F4
The surgeon grasped the needle with anatomical forceps and extracted it from the heart gently, without incising the muscle (Figure 4). 