Key result
Pericardial drain removal after subxiphoid pericardiocentesis triggers severe hemoperitoneum from unrecognized liver puncture.
Why the study?
Catheter ablation for atrial fibrillation can cause acute cardiac tamponade requiring pericardiocentesis, which itself can result in serious complications such as liver bleeding, ventricular puncture, and pneumothorax.
Case Report (n=1)
No
Clinicians should consider CT imaging before removing a pericardial drainage tube placed via the subxiphoid approach to rule out liver puncture, even if liver enzymes are normal.
Answers are grounded in this paper and cite their sources.
Alerts to hemoperitoneum risk after subxiphoid tube removal; case report leaves open whether pre-removal imaging prevents injury.
Cryoballoon-based pulmonary vein (PV) isolation is a highly effective method for the treatment of atrial fibrillation (AF).1 Nonetheless, catheter ablation can result in serious procedural complications, the mostly likely of which is acute cardiac tamponade.2 Life-saving emergency pericardiocentesis for the aspiration of pericardial fluid and restoration of hemodynamics is required for acute cardiac tamponade. However, the life-saving procedure of pericardiocentesis can result in serious complications, such as liver bleeding, ventricular puncture, and pneumothorax.
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Kasai et al. (2022) conducted a case report in Atrial fibrillation with acute cardiac tamponade (n=1). Subxiphoid pericardiocentesis and pericardial drainage tube removal was evaluated. Removal of a pericardial drainage tube after subxiphoid pericardiocentesis triggered severe hemoperitoneum from an unrecognized liver puncture.
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