Lorenzoni Giovanni, Merella Pierluigi, Pischedda Paolo, Casu Gavino
Ospedale San Francesco, Unità Operativa Complessa di Cardiologia, via Mannironi 1, Nuoro, Italy.
J Invasive Cardiol. 2018 Nov;30(11):E126-E127.
Left atrial appendage (LAA) perforation is a possible complication not only after release of the closure device, but also during the diagnostic phase due to sheath positioning in the LAA. We present an 83-year-old woman with permanent atrial fibrillation and high thromboembolic and bleeding risk who was admitted for elective percutaneous LAA closure. During angiographic study, she suddenly became hypotensive. Heart perforation with leakage of contrast in the pericardial space was evident and imaging confirmed cardiac tamponade. Rapid release of the closure device and pericardial evacuation allowed the operators to successfully manage the cardiac tamponade and avoid a surgical option.
左心耳（LAA）穿孔不仅是封堵装置释放后可能出现的并发症，在诊断阶段由于鞘管置于左心耳内也可能发生。我们报告一名83岁患有永久性房颤且血栓栓塞和出血风险高的女性，因择期经皮左心耳封堵入院。在血管造影研究过程中，她突然出现低血压。心包腔内造影剂渗漏提示心脏穿孔，影像学检查确诊为心脏压塞。迅速释放封堵装置并进行心包引流，使术者成功处理了心脏压塞，避免了手术治疗。
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