Percutaneous occlusion of transseptal puncture-related free wall perforation at the coronary sinus with a ventricular septal occluder during left atrial appendage closure: A case report.
Catheter Cardiovasc Interv
; 96(7): E755-E757, 2020 12.
Article
em En
| MEDLINE
| ID: mdl-31696654
ABSTRACT
Coronary sinus perforation is a life-threatening complication of transseptal puncture and needs to be repaired immediately. In this study, we report a case of a 74-year-old female patient with nonvalvular atrial fibrillation, who is a poor long-term anticoagulation candidate. During the manipulation of transseptal puncture, a perforation of the free right atrial wall at the coronary sinus ostium occurred, which was caused by the Brockenbrough needle and followed by the immediate advancement of an 8.5-French transseptal sheath. In consideration of the danger of cardiac tamponade after sheath removal, we decided to leave the 8.5-French sheath in the pericardial cavity. Then, we advanced a 6 mm ventricular septal occluder through the sheath. Finally, we achieved successful deployment of the device and closure of the perforation under the guidance of fluoroscopy and transthoracic echocardiography. Subsequently, the left atrial appendage orifice was occluded with a 21 mm Watchman device. This case illustrates that percutaneous device closure is feasible for inadvertent perforation of the free right atrial wall at the coronary sinus during transseptal puncture and should be considered as an alternative to surgery.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Cateterismo Cardíaco
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Técnicas Hemostáticas
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Seio Coronário
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Dispositivo para Oclusão Septal
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Lesões do Sistema Vascular
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Traumatismos Cardíacos
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Septos Cardíacos
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
China