Clinical Research in Cardiology

, Volume 103, Issue 7, pp 577–579 | Cite as

Angio-Seal closure of an iatrogenic right ventricular perforation

  • Ali Pourdjabbar
  • Benjamin Hibbert
  • Paul Hendry
  • Marino LabinazEmail author
Letter to the Editors


Vascular closure devices are commonly used following arteriotomy as they improve patient comfort, provide rapid hemostasis, and shorten discharge time following coronary angiography [3]. The off-label use of these devices is relatively uncommon and limited to other arterial injuries [1, 4].

Pericardiocentesis is frequently performed for diagnosis and therapeutic management of hemodynamically significant pericardial effusions. Although relatively safe, complication rates between 1.0 and 4.8 % have been reported—including pneumothorax, ventricular puncture and liver laceration [5]. Ventricular perforation, while infrequent (incidence rate between 0.4 and 1.4 %) is the most serious complication, which is typically managed surgically. Herein, we report a case of an iatrogenic placement of a pigtail catheter in the right ventricle (RV), which was successfully closed via Angio-Seal collagen-based arterial closure device.

A 75-year-old male with past medical history of recurrent large B...


Right Ventricle Pericardial Effusion Closure Device Pigtail Catheter Supplemental Video 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We would like to thank Drs. Talal Al-Atassi, Rebecca Hibbert, Chi Lai and Girish Dwivedi for their assistance during the case and in preparing this report.

Conflict of interest

There are no conflicts of interest to declare.

Supplementary material

Video 1

Echocardiogram subcostal view post Definity contrast injection through the pigtail catheter demonstrating presence of contrast within the RV and RA (MOV 3231 kb)

Video 2

Angiography post contrast injecting through the catheter demonstrating the presence of contrast dye with the right ventricle (MOV 1443 kb) (2.3 mb)
Video 3 Demonstrating the Angio-Seal closure device within the chest cavity following the deployment of the collagen plug within the RV. The successful deployment was confirmed by cessation of bleeding from the insertion site on the chest as well as lack pericardial fluid re-accumulation via echocardiography (MOV 2304 kb)


  1. 1.
    Massiere B, von Ristow A, Cury JM, Gress M, Vescovi A, Pedron C, Medina AL, Masques MA, Silveira PR, Jeha S (2009) Closure of carotid artery puncture site with a percutaneous device. Ann Vasc Surg 23(256):e255–e257Google Scholar
  2. 2.
    Petrov I, Dimitrov C (2009) Closing of a right ventricle perforation with a vascular closure device. Catheter Cardiovasc Interv 74:247–250PubMedGoogle Scholar
  3. 3.
    Schwartz BG, Burstein S, Economides C, Kloner RA, Shavelle DM, Mayeda GS (2010) Review of vascular closure devices. J Invasive Cardiol 22:599–607PubMedGoogle Scholar
  4. 4.
    Shetty SV, Kwolek CJ, Garasic JM (2007) Percutaneous closure after inadvertent subclavian artery cannulation. Catheter Cardiovasc Interv 69:1050–1052PubMedCrossRefGoogle Scholar
  5. 5.
    Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ, Bailey KR, Seward JB (2002) Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc 77:429–436PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ali Pourdjabbar
    • 1
  • Benjamin Hibbert
    • 1
  • Paul Hendry
    • 2
  • Marino Labinaz
    • 1
    Email author
  1. 1.Division of CardiologyUniversity of Ottawa Heart InstituteOttawaCanada
  2. 2.Division of Cardiac SurgeryUniversity of Ottawa Heart InstituteOttawaCanada

Personalised recommendations