Angio-Seal closure of an iatrogenic right ventricular perforation
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Vascular closure devices are commonly used following arteriotomy as they improve patient comfort, provide rapid hemostasis, and shorten discharge time following coronary angiography . 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 . 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.
KeywordsRight Ventricle Pericardial Effusion Closure Device Pigtail Catheter Supplemental Video
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.
Echocardiogram subcostal view post Definity contrast injection through the pigtail catheter demonstrating presence of contrast within the RV and RA (MOV 3231 kb)
Angiography post contrast injecting through the catheter demonstrating the presence of contrast dye with the right ventricle (MOV 1443 kb)
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