Severe hemothorax complications during atrial fibrillation ablation: Lessons from two cases

Figures

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  Figure 1. A: Voltage map with lesion tags during pulmonary vein isolation in case 1: inner view of right pulmonary vein and front view of left atrium. B: Contrast-enhanced computed tomography of the hematoma and contrast leakage from the right intercostal artery (red arrow). C: Aortography demonstrating extravasation from the right eighth intercostal artery (red arrow) and digital subtraction image after embolization of the right eighth intercostal artery with coils. D: Contrast-enhanced computed tomography of an enlarged hematoma within the right chest wall. E: Thoracoscopic removal of intrathoracic hematoma and coagulation therapy with argon plasma.

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  Figure 2. A: Voltage map with lesion tags during pulmonary vein isolation in case 2: inner view of right pulmonary vein and front view of left atrium. B: Noncontrast computed tomography of a massive hematoma in the right thoracic cavity. C: Front view of a preoperative contrast-enhanced computed tomography image. The right eighth intercostal artery branches off from the descending aorta at the level of the left atrium base and travels to the right side (red arrow). D: Right lateral view. The right eighth intercostal artery runs through a very narrow posterior mediastinum between the posterior wall of the left atrium and the vertebral body. E: Axial view. The right inferior pulmonary vein and vertebral body sandwich the eighth intercostal artery (red circle).