Background: Cardiac tamponade is one of the most serious complications when performing cardiac interventions. Although most of the patients can be treated effectively using pericardiocentesis, urgent surgery can be necessary in case of continuous bleeding and patients' haemodynamic impairment.
Case Summary: With this unique clinical case report we describe an acute endovascular occlusion of a cardiac perforation utilizing the inflated 28 mm cryoballon at the transseptal puncture site close to the superior part of the coronary sinus ostium in a patient with persistent left superior vena cava (PLSVC) and severe post-procedural tamponade. Prior to this maneuver, 1200 mL of haemorrhagic effusion has been aspirated. Forty-five minutes after cryoballoon-guided occlusion we deflated the balloon and no additional blood could be aspirated over the following 20 minutes.
Discussion: Cryoballon-guided occlusion of the perforation site saved the patient from immediate cardiac surgery and resulted in stable haemodynamic conditions. This bailout approach was transferred from coronary interventions where occlusion of a perforated vessel using balloon devices is a common technique to achieve acute hemostasis.
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http://dx.doi.org/10.1093/ehjcr/ytaa056 | DOI Listing |
JACC Case Rep
January 2025
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Fibrosing mediastinitis is a rare chronic inflammatory condition characterized by excessive fibrotic process in the mediastinum. Although various infectious processes are more common causes, it can also be related to several malignancies. We report a case of a 28-year-old woman with fibrosing mediastinitis related to an aggressive primary gray-zone lymphoma causing complete occlusion of the superior vena cava (SVC) and the innominate veins.
View Article and Find Full Text PDFA 65-year-old patient was admitted to the Institute with complaints of shortness of breath, palpitation, and limb edema. Comorbidities were type 2 diabetes mellitus, gout, obesity. Echo: left ventricular ejection fraction 22%, left ventricular aneurysm (LVA), floating thrombus 5.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8 - 00168 Rome, Italy.
Background: Cardiac strangulation (CS) from epicardial pacing leads (EPLs) is a rare and potentially lethal mechanical complication associated with epicardial pacemaker (PM) implantation.
Case Summary: We report a case of a 44-year-old-female patient presenting with chest and left shoulder pain in the absence of reported trauma with history of congenital atrioventricular block treated with epicardial PM implantation during the childhood and subsequent transvenous reimplantation over the years. Troponin I resulted within normal values and ECG, transthoracic echocardiography and chest X-ray documented no acute cardiopulmonary findings.
Case Rep Cardiol
January 2025
Department of Cardiology, Toyohashi Heart Center, Toyohashi, Aichi, Japan.
We present a case of a 60-year-old man with claudication in his right foot; the patient had received stent-graft implantation for the right superficial femoral artery (SFA) 1 year ago. Computed tomography angiography suggested stent occlusion of the right SFA, and a thrombus was considered to cause occlusion. To avoid distal embolization, we performed lesion recanalization via a trans-ankle intervention.
View Article and Find Full Text PDFCardiovasc Interv Ther
January 2025
Department of Internal Medicine, Division of Cardiology, Iwate Medical University, 2-1-1 Idaidori, Yahaba-Cho, Shiwa-Gun, Iwate, 028-3695, Japan.
In clinical practice, the impact of procedural or patient-related risk factors on 1-year clinical outcomes in patients receiving 1-month of dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy after contemporary percutaneous coronary intervention (PCI) remains unclear. Using data from the multi-center REIWA registry which included patients treated with thin-strut biodegradable polymer drug-eluting stent (BP-DES) and 1-month DAPT followed by P2Y12 inhibitor monotherapy, we assessed the primary endpoint (a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, ischemic or hemorrhagic stroke, and major or minor bleeding) in patients with and without procedural (treatment of three vessels, three or more lesions, three or more stents, bifurcation with two stents, long stenting, and target of chronic total occlusion) and patient-related risk factor (renal insufficiency, anemia, peripheral vascular disease, prior or current history of heart failure and advanced age of ≥ 75 years). Among the 1,202 patients who underwent complete revascularization by PCI, 276 (23.
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