Coronary and Right Ventricular Perforations: Frying pan and the Fire

Abstract

Background: Pericardiocentesis is a challenging procedure, particularly in the setting of acute cardiac tamponade (CT) following coronary perforation during percutaneous intervention (PCI).

Case Presentation: In the case presented here, an ad hoc PCI procedure was performed on the Left Anterior Descending (LAD) artery, which resulted in coronary artery perforation and subsequent acute cardiac tamponade. Emergency pericardiocentesis was promptly performed; however, an additional complication of right ventricular (RV) perforation occurred, necessitating specialized management.

Management & Results: The coronary perforation was successfully managed using a covered stent, while the RV perforations were addressed through the deployment of a Patent Ductus Arteriosus occluder device and subsequent surgical patch repair.

Conclusion: This case emphasizes the critical importance of having the necessary equipment, involving multiple modalities, and possessing expertise in order to effectively manage complications arising from cardiac catheterization procedures. The availability of appropriate hardware and a multidisciplinary approach can significantly contribute to life-saving interventions in such situations.