Angio-Seal for Right Ventricle Perforation During Pericardiocentesis for Cardiac Tamponade: A Case Report

Journal of the Society for Cardiovascular Angiography & Interventions Pub Date : 2025-07-01 DOI:10.1016/j.jscai.2025.103719

Soleiman Aria MBBS, MA(Cantab), MRCP, MSc , Su Hnin Hlaing MBBS, MMed, MRCP, FRACP , Rustem Dautov MD, PhD, FRACP, FCSANZ , Darren L. Walters MBBS, MPhil, FRACP, FCSANZ, FSCAI

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Abstract

Cardiac tamponade is often managed with pericardiocentesis, carrying a 1% to 4% complication risk, including right ventricle perforation. Small punctures are typically managed conservatively, while larger ones require cardiac surgery. This case describes percutaneous Angio-Seal (Terumo) repair in a high-risk surgical patient. A 46-year-old obese woman with multiple comorbidities presented with recurrent tamponade. After inserting a pericardiocentesis catheter it was noticed that despite draining 1000 mL of blood, tamponade persisted. The catheter was inadvertently placed in the right ventricle. After anticoagulation subsided, an 8F Angio-Seal catheter was deployed under imaging, successfully sealing the perforation. This case highlights the safety of Angio-Seal in high-risk patients with right ventricle perforation.

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心包穿刺治疗心包填塞时右心室穿孔血管封闭一例报告

心包填塞通常采用心包穿刺治疗，有1%至4%的并发症风险，包括右心室穿孔。小的穿刺通常保守处理，而大的穿刺则需要心脏手术。本病例描述了一个高风险手术患者的经皮血管密封（Terumo）修复。一位46岁肥胖女性，多重合并症表现为复发性填塞。在插入心包穿刺导管后，尽管抽出了1000毫升的血液，但填塞仍然存在。导管不慎插入右心室。抗凝消退后，在显像下放置8F Angio-Seal导管，成功封堵穿孔。本病例强调了右心室穿孔高危患者血管密封的安全性。

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