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Published on: June 12, 2021
Percutaneous Management of Left Ventricular Perforation Causing Late Cardiac Tamponade After Transcatheter Aortic
Krishnarpan Chatterjee1, Pyotr Telyuk1, Stuart W Grant1
1Academic Cardiovascular Unit, James Cook University Hospital, Middlesbrough, United Kingdom.
Background:
We present a case of left ventricular perforation and delayed cardiac tamponade after transcatheter aortic valve implantation (TAVI) managed percutaneously. This report describes a novel technique for management of left ventricular perforation after TAVI.
Case Summary:
We performed elective transfemoral TAVI in a frail 85-year-old lady. Anatomical challenges included tortuous and horizontal aorta and a small left ventricular cavity. A 23-mm Sapien valve was implanted. She developed cardiac tamponade the next day needing emergency pericardiocentesis. Left ventricular angiogram showed perforation of the lateral wall. SURGIFLO Hemostatic Matrix was injected into the pericardial space using Agilis steerable introducer with a good outcome.
Discussion:
Cardiac perforation and tamponade are serious and potentially fatal complications after TAVI. The outcomes in these patients remain poor with high mortality rate even with emergent cardiac surgery. This report describes a novel technique for management of left ventricular perforation after TAVI.
