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Left ventricular pseudoaneurysm after pericardiocentesis.

Francesco Patanè¹, Fabrizio Sansone, Paolo Centofanti

¹Division of Cardiac Surgery, S Giovanni Battista Hospital, Turin, Italy. f_patane@hotmail.com

Interactive Cardiovascular and Thoracic Surgery

|August 14, 2008

Summary

This summary is machine-generated.

A rare complication of pericardiocentesis, iatrogenic left ventricular pseudoaneurysm, occurred in a patient with recurrent pericardial effusion. Surgical repair successfully excluded the pseudoaneurysm, highlighting the need for vigilance in high-risk individuals.

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Area of Science:

Cardiology
Cardiac Surgery

Background:

Recurrent pericardial effusion and fever can necessitate pericardiocentesis for cardiac tamponade.
Pericardiocentesis, while therapeutic, carries potential iatrogenic risks.

Observation:

A patient developed a suspected left ventricular puncture during pericardiocentesis, evidenced by arterial blood aspiration.
Following surgical drainage for presumed infective pleuro-pericarditis, the patient later presented with congestive heart failure and fever.

Findings:

Urgent echocardiography and CT-scanning revealed a large left ventricular apex pseudoaneurysm (26 mm x 36 mm).
Ventriculography confirmed the pseudoaneurysm's connection to the left ventricular apex.
Surgical exclusion of the pseudoaneurysm was successfully achieved using a Prolene suture and bovine pericardium, avoiding cardiopulmonary bypass.

Implications:

Iatrogenic pseudoaneurysm is a very rare but serious complication of pericardiocentesis.
Identifying high-risk patients and meticulous technique are crucial for preventing this complication.
Successful surgical management of iatrogenic left ventricular pseudoaneurysm is possible.