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Case Reports
. 2018 Jul-Sep;21(3):290-292.
doi: 10.4103/aca.ACA_115_17.

Pericardiocentesis can be nasty. Accidents do occur while "Rail-roading" Sheaths and pigtails!

Jitin Narula  1 , Arindam Choudhury  1 , Arun Sharma  1
Affiliations
Case Reports

Pericardiocentesis can be nasty. Accidents do occur while "Rail-roading" Sheaths and pigtails!

Jitin Narula et al. Ann Card Anaesth. 2018 Jul-Sep.

Abstract

Pericardiocentesis is a challenging procedure and complications may vary depending on the patient-specific risk factors and procedural indications. Cardiac chamber perforation and the subsequent insertion of pigtail catheter into the main pulmonary artery are an unreported mishap during attempted pericardiocentesis. This potentially life-threatening complication is completely preventable by identification of high-risk patients and appropriate use of available technologies. Adjunctive imaging decreases procedural risk for difficult-to-access pericardial fluid collections and must be used to prevent inadvertent morbidities.

Keywords: Cardiac imaging techniques; cardiac rupture; complications; pericardial effusion; pericardiocentesis.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
Computed tomography sagittal oblique reformatted image showing the pigtail catheter coursing through right ventricular outflow tract (black arrow) and main pulmonary artery (white arrow)
Figure 2
Figure 2
Midesophageal right ventricular inflow-outflow view showing the entry point of the sheath and pigtail assembly into the right ventricle and the coursing of the pigtail catheter toward the right ventricular outflow tract
Figure 3
Figure 3
Percutaneously inserted sheath and pigtail catheter seen entering the right ventricular anterior free wall after piercing the thickened pericardium
See this image and copyright information in PMC

References

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