title: Haemostasis with fibrin glue injection into the pericardial space for right ventricular perforation caused by an iatrogenic procedural complication.
abstract: An 89-year-old woman with severe aortic valve stenosis and bradycardia presented with circulatory shock due to cardiac tamponade. We performed pericardiocentesis, and then diagnosed right ventricular perforation by echocardiography with microcavitation contrast medium just before inserting a drainage tube. We then inserted the drainage tube in the appropriate position and withdrew blood-filled fluid. The patient was haemodynamically stabilised, but haemorrhage from the perforation site continued for a few days. We injected fibrin glue into the pericardial space through the drainage tube and achieved haemostasis. Thus, we avoided surgery to close the perforation in this high-risk patient. There was no recurrence of haemorrhage. She subsequently had elective aortic valve replacement at another hospital. No adhesions in the pericardial space were seen during surgery.
authors.affiliation: Department of Cardiology, Musashino Sekijuji Byoin, Musashino, Tokyo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Arai
authors.affiliation: Department of Cardiology, Musashino Sekijuji Byoin, Musashino, Tokyo, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Department of Cardiology, Musashino Sekijuji Byoin, Musashino, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hara
authors.affiliation: Department of Cardiology, Musashino Sekijuji Byoin, Musashino, Tokyo, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Obayashi
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications; D001919:Bradycardia / Q000150:complications; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006335:Heart Injuries / Q000209:etiology*; D006487:Hemostasis; D006801:Humans; D007049:Iatrogenic Disease; D020519:Pericardiocentesis / Q000009:adverse effects*; D010496:Pericardium; D019106:Postoperative Hemorrhage / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive