Compressive Intrapericardial Hematoma Following Thoracotomy to Seal Coronary Artery Perforation

A 68-year-old male developed cardiac tamponade secondary to coronary artery perforation following percutaneous coronary artery intervention. He underwent thoracotomy to seal the perforation of the acute marginal branch of the right coronary artery. Following sealing of perforation with application of cyanoacrylate to the right atrioventricular groove, the patient remained stable with minimal pericardial effusion for 1 month and later developed a large (6 cm × 5 cm) intrapericardial hematoma compressing the right ventricular inflow with intermittent fever. The patient declined repeat surgery and showed some regression of hematoma and a decrease in trans-tricuspid pressure gradients with colchicine after 1 month. The case is reported for its rarity with a review of literature.