Case report: Unusual presentation of haemopericardium with haemodynamic instability secondary to a coronary graft pseudoaneurysm treated by an endovascular approach

Arvin Haghighat; Thomas H Burke; John W D Speirs; Anthony E Glanz

doi:10.1093/ehjcr/yty147

Case report: Unusual presentation of haemopericardium with haemodynamic instability secondary to a coronary graft pseudoaneurysm treated by an endovascular approach

Eur Heart J Case Rep. 2018 Dec 7;2(4):yty147. doi: 10.1093/ehjcr/yty147. eCollection 2018 Dec.

Authors

Arvin Haghighat¹, Thomas H Burke², John W D Speirs³, Anthony E Glanz⁴

Affiliations

¹ Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
² MicroVention-Terumo, Tustin, CA, USA.
³ Division of Interventional Radiology, Department of Radiology, Windsor Regional Hospital, Windsor, ON, Canada.
⁴ Division of Cardiology, Department of Medicine, Windsor Regional Hospital, Windsor, ON, Canada.

Abstract

Background: We report the successful endovascular treatment of a coronary graft pseudoaneurysm using a technique often seen in intracranial aneurysm coiling.

Case summary: We present an unusual case of a patient who presents with haemopericardium and haemodynamic instability after saphenous vein bypass grafting. A pseudoaneurysm rapidly expanded from 5 cm to 7 cm over the follow-up period producing compressive mass effect on the lateral right ventricle with transient haemodynamic instability. The patient's declining clinical condition did not warrant a redo thoracotomy and sternotomy, so an endovascular approach was deemed to be the best treatment option.

Discussion: The use of endovascular embolization techniques is indeed a technically viable alternative with positive outcomes without the need for thoracotomy and sternotomy.

Keywords: Cardiac pseudoaneurysm; Case report; Endovascular coiling; Haemopericardium.

Publication types

Case Reports