Iatrogenic Cardiac Tamponade During Endovascular Aortic and Mesenteric Stent Grafting

Abstract

The authors report a case of left ventricular perforation and cardiac tamponade in a patient undergoing endovascular aortic and mesenteric stent grafting. During the procedure, the anesthetist noticed a sudden increase in central venous pressure and a decrease in blood pressure. Cardiac tamponade was suspected and confirmed by transesophageal echocardiography. Pericardiotomy resulted only in temporary stabilization. Emergency sternotomy revealed left ventricular perforation. Both anesthetists and radiologists have to be aware of such rare but severe complications of interventional procedures.

Pericardial Tamponade during Supra Hepatic IVC Angioplasty in Budd-Chiari Syndrome Managed by Ultrasound-Guided Pericardiocentesis

“…1 2 The endovascular procedure with highest incidence of pericardial hemorrhage includes IVC filter with strut fracture/migration. 3 Other causes excluding intracardiac/coronary procedures include mediastinal biopsies, 4 aortic stent-graft placement, 5 and central venous port insertion. 6 IVC-RA junction is in close relation with the pericardium that forms a recess around the vena cava.…”