Key result
Percutaneous injection of SURGIFLO Hemostatic Matrix into the pericardial space successfully sealed a left ventricular perforation and resolved delayed cardiac tamponade after TAVI.
Why the study?
Cardiac perforation and tamponade after TAVI carry high mortality even with emergent surgery, prompting the need for novel percutaneous management techniques.
Can left ventricular perforation causing delayed cardiac tamponade after TAVI be successfully managed percutaneously using a hemostatic matrix?
Case Report (n=1)
No
Can left ventricular perforation causing delayed cardiac tamponade after TAVI be successfully managed percutaneously using a hemostatic matrix?
This case report demonstrates a novel, potentially life-saving percutaneous technique using a hemostatic matrix to manage left ventricular perforation after TAVI.
May offer percutaneous option for post-TAVI LV perforation in select anatomy; leaves open need for prospective validation.
BACKGROUND: We present a case of left ventricular perforation and delayed cardiac tamponade after transcatheter aortic valve implantation (TAVI) managed percutaneously. This report describes a novel technique for management of left ventricular perforation after TAVI. CASE SUMMARY: We performed elective transfemoral TAVI in a frail 85-year-old lady. Anatomical challenges included tortuous and horizontal aorta and a small left ventricular cavity. A 23-mm Sapien valve was implanted. She developed cardiac tamponade the next day needing emergency pericardiocentesis. Left ventricular angiogram showed perforation of the lateral wall. SURGIFLO Hemostatic Matrix was injected into the pericardial space using Agilis steerable introducer with a good outcome. DISCUSSION: Cardiac perforation and tamponade are serious and potentially fatal complications after TAVI. The outcomes in these patients remain poor with high mortality rate even with emergent cardiac surgery. This report describes a novel technique for management of left ventricular perforation after TAVI.
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Chatterjee et al. (2025) conducted a case report in Left ventricular perforation and delayed cardiac tamponade after TAVI (n=1). Percutaneous injection of SURGIFLO Hemostatic Matrix via Agilis steerable introducer was evaluated on Resolution of cardiac tamponade and sealing of left ventricular perforation. Percutaneous injection of SURGIFLO Hemostatic Matrix into the pericardial space successfully sealed a left ventricular perforation and resolved delayed cardiac tamponade after TAVI.
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