This case provides the first description of successful percutaneous drainage for a compressive left atrial hematoma causing cardiovascular collapse after CTO PCI.
May support percutaneous drainage for post-CTO PCI left atrial hematoma; hypothesis-generating and leaves open need for prospective validation.
This case illustrates a potential complication of the retrograde approach using epicardial collaterals for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Hypotension post CTO PCI in a patient who has undergone previous cardiac surgery can have multiple causes, one of which is chamber compression from a localized hematoma due to coronary perforation as occurred in this case. This report is the first description of successful nonsurgical management of a left atrial hematoma causing cardiovascular collapse with percutaneous drainage.
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Wilson et al. (2014) studied this question.
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