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Transcatheter Closure of Iatrogenic Right Ventricular Perforation With Amplatzer Duct Occlude II
Parag Sumatilal Bhalgat1,2, Prashant Prakash Kharche2, Ashish Agrawal2
1Sujyot Heart Clinic, Matunga, Mumbai, India.
Insights
Transcatheter intervention offers a successful bailout for iatrogenic cardiac perforation, specifically right ventricular perforation, when open heart surgery poses high risks during the COVID-19 pandemic.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Iatrogenic cardiac perforation is a serious complication during cardiac interventions.
- Standard treatment for cardiac perforation involves surgical correction.
- The COVID-19 pandemic presented unique challenges for surgical procedures.
Observation:
- A patient experienced right ventricular perforation due to a pacing wire during the COVID-19 pandemic.
- The patient's advanced age and severe COVID-19 related lung disease made open heart surgery a high-risk option.
Findings:
- Transcatheter intervention was employed as a bailout strategy for the right ventricular perforation.
- The transcatheter closure of the perforation was technically successful.
Implications:
- This case demonstrates the feasibility of transcatheter intervention for managing iatrogenic cardiac perforation in high-risk patients.
- Minimally invasive transcatheter techniques may offer a viable alternative to surgery in specific complex scenarios.
- This approach could be crucial for managing cardiac complications during pandemics when surgical resources are strained.
Abstract:
Iatrogenic cardiac perforation is a major complication of cardiac intervention. Surgical correction of perforation is standard of care. We discuss a pacing wire induced right ventricular perforation during the coronavirus disease-2019 (COVID-19) pandemic. Open heart surgery was high risk due to age and COVID-related significant lung involvement. As a bailout measure, the perforation was successfully closed with transcatheter intervention. (Level of Difficulty: Advanced.).
