Cardiac perforation and tamponade during transjugular intrahepatic portosystemic shunt placement.
A patient developed acute severe hemodynamic compromise during a transjugular intrahepatic portosystemic shunt (TIPS) procedure for intractable ascites. Rapid clinical and radiographic evaluation of the patient disclosed pericardial blood and cardiac tamponade as the cause, probably due to right heart perforation from guidewire and catheter manipulation. The tamponade was successfully treated percutaneously, and the patient survived. Cardiac tamponade should be considered in the differential diagnosis of patients who develop hypotension during TIPS placement.
McCowan
T C
TC
Department of Radiology, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, USA.
Hummel
M M
MM
Schmucker
T
T
Goertzen
T C
TC
Culp
W C
WC
Habbe
T G
TG
D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004452:Echocardiography; D006335:Heart Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications; D017093:Liver Failure / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D013902:Radiography, Thoracic; D013396:Suction