title: Cardiovascular collapse post chronic total occlusion percutaneous coronary intervention due to a compressive left atrial hematoma managed with percutaneous drainage.
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.
authors.affiliation: Edinburgh Heart Centre, Edinburgh, Scotland, United Kingdom.
authors.forename: William M
authors.initials: WM
authors.lastname: Wilson
authors.affiliation: Edinburgh Heart Centre, Edinburgh, Scotland, United Kingdom.
authors.forename: J C
authors.initials: JC
authors.lastname: Spratt
authors.affiliation: Department of Cardiology, St Joseph Hospital, Bellingham, Washington.
authors.forename: W L
authors.initials: WL
authors.lastname: Lombardi
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017023:Coronary Angiography; D004322:Drainage; D054855:Drug-Eluting Stents; D004452:Echocardiography; D006325:Heart Atria / Q000293:injuries* / Q000601:surgery*; D006335:Heart Injuries / Q000209:etiology* / Q000601:surgery*; D006406:Hematoma / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed
keywords: angioplasty; complication; epicardial collaterals; hypotension