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Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat
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A drainage catheter tangled around a closed left atrial appendage
Koshi Sawada1, Hideki Kitamura2, Yutaka Koyama1
1Department of Cardiovascular Surgery, Nagoya Heart Center, 1-1-14 Sunadabashi, Higashi-ku, Nagoya, Aichi, 461-0045, Japan.
General Thoracic and Cardiovascular Surgery
|May 19, 2019
Summary
A pigtail catheter became stuck during removal after left atrial appendage closure due to the appendage hardening. Specialized techniques were needed to safely retrieve the catheter, highlighting a potential complication.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Device Complications
Background:
- Left atrial appendage closure is a common procedure following cardiac surgery.
- Delayed pericardial tamponade necessitates drainage catheter insertion into the pericardial sac.
- Routine catheter removal is typically uncomplicated.
Observation:
- A pigtail catheter inserted for delayed tamponade drainage became difficult to remove 2 days post-insertion.
- High, pulsatile resistance was encountered during attempted catheter removal.
- Imaging revealed the catheter was entrapped around the left atrial appendage.
Findings:
- The left atrial appendage, normally soft and shrinkable, can become firm and unshrinkable after closure.
- This hardened appendage obstructed the drainage catheter, preventing its removal.
- Successful catheter retrieval required intervention in a catheterization laboratory.
Implications:
- Physicians should be aware of the potential for left atrial appendage closure to alter appendage mechanics.
- Difficult catheter removal post-cardiac surgery may indicate entrapment by a hardened appendage.
- Further research into preventing or managing this specific complication is warranted.
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