ObjectivesLeft atrial dissection (LatD) is a rare and heterogeneous condition affecting many cardiovascular areas. The present article, by the means of personal case report illustration and systemic review of different clinical management, is aimed to give to clinicians further knowledge on this controversial topic.BackgroundLatD is an exceedingly rare but potentially fatal complication of cardiac surgery or catheter‐based interventional procedures. Most of the cases are iatrogenic and its incidence is expected to grow due to an increase in the number of percutaneous coronary intervention and structural heart disease procedures. The management of this complication is controversial, and it may depend on related etiologies.MethodsWe have reported our single‐case experience and review of the scientific literature, focusing on the decision‐making process and the strategical approach by multimodality imaging techniques.ResultsOur case of LatD with initial hemodynamic instability was surgically treated. Conservative approach is often employed in literature despite the fact that conservative versus surgical approach is debatable, depending on clinical presentation, hemodynamic stability, multimodal imaging findings, and personal experience of the center.ConclusionsAccording to systematic literature review, a watchful‐waiting strategy supported by multimodality imaging could be a safe and effective management in stable LatD.
Background
Iatrogenic hemorrhagic pericardial tamponade (IHPT) represents a life‐threating condition requiring emergency pericardiocentesis. In this clinical context, reinfusion of pericardial blood can stabilize the patient and sustain hemodynamic conditions.
Aims and Methods
We reviewed all cases of IHPT occurred at our hospital over a 10 years span. In all patient autologous blood reinfusion through a femoral vein was performed.
Results
In our clinical experience of 30 consecutive patients with hemorrhagic cardiac tamponade, this technique was successful to limit blood transfusions, to prevent further clinical worsening and bridge patients with intractable bleeding, to cardiac surgery. No major adverse reactions were directly related to blood autotransfusion.
Conclusion
In the complex clinical scenario of acute tamponade occurring during catheter‐based cardiac procedures, autotransfusion of pericardial blood through a femoral vein is safe and effective. It can be a useful trick up the sleeve of the interventional cardiologist.
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