Cardiovascular collapse post chronic total occlusion percutaneous coronary intervention due to a compressive left atrial hematoma managed with percutaneous drainage

Catheter Cardiovasc Interv. 2015 Sep;86(3):407-11. doi: 10.1002/ccd.25571. Epub 2015 Jun 29.

Abstract

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.

Keywords: angioplasty; complication; epicardial collaterals; hypotension.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Chronic Disease
  • Coronary Angiography
  • Drainage
  • Drug-Eluting Stents
  • Echocardiography
  • Heart Atria / injuries*
  • Heart Atria / surgery*
  • Heart Injuries / etiology*
  • Heart Injuries / surgery*
  • Hematoma / etiology*
  • Hematoma / surgery*
  • Humans
  • Male
  • Percutaneous Coronary Intervention / adverse effects*
  • Radiography, Interventional
  • Tomography, X-Ray Computed