Two episodes of cardiac tamponade in the same patient from removing pacing wires and a pericardial drain: A case report

Abstract

A patient presented for an elective transcatheter aortic valve replacement with temporary transvenous pacing (TVP) wires placement per protocol. On postoperative day 1, the patient remained stable, so the wires were subsequently removed, after which the patient acutely decompensated, with transthoracic echocardiography revealing pericardial effusion. Emergent pericardiocentesis was performed, and a pericardial drain was placed. Three days later, the drain was removed; again, the patient acutely decompensated, requiring another emergent pericardiocentesis. Despite the relatively benign nature of TVP wires and pericardial drains, the possibility of cardiac tamponade should be kept in mind as a potential complication when they are being removed.

Figure 1

Transthoracic echocardiogram showing temporary pacing wire in the right ventricle

Figure 2

Transthoracic echocardiogram after removal of pacing wires, yellow arrow shows pericardial effusion around the right ventricle