The Narrative of an Aberrant Pericardiocentesis Catheter in the Heart: A Case Report on the Surgical Management of an Iatrogenic Left Ventricle Perforation

Abstract

Pericardiocentesis catheter placement is a procedure for treating pericardial effusion and has a low complication rate. Inadvertent intraventricular perforation of a pericardiocentesis catheter is an uncommon yet a known complication of the procedure. Failure to establish adequate hemostasis during the removal of the foreign body could be catastrophic. Generically, puncture of a pericardiocentesis catheter into the ventricular space is tolerable, but the failure to achieve hemostasis in the ventricular wall amounts to injurious effects accounted to the size and caliber of the drain. Here we describe a case in which a pigtail catheter (8F) accidentally penetrated the left ventricle while attempting to drain pericardial effusion. The patient was brought to the surgical theater where the cardiac surgeon performed an off-pump left anterolateral thoracotomy and extracted the drain successfully. Pledgetted sutures (Prolene 3-0) were placed under tension and the knots were placed, thereby achieving excellent hemostasis of entry point of perforation. During the postoperative course, neither the x-ray of the chest nor an echocardiograph demonstrated hemothorax or pericardial tamponade. Five days later, the patient was discharged from our hospital.