Dataset Information

A case report of right ventricular compression from a septal haematoma during retrograde coronary intervention to a chronic total occlusion.

ABSTRACT:

Background

Septal haematomas causing left ventricular or biventricular outflow obstruction are rare but known complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can be life-threatening.

Case summary

In this case, we describe the formation of a septal haematoma during retrograde CTO PCI. The patient was initially managed conservatively but became progressively unstable, for which she underwent coiling of the inflow and outflow of the septal perforator. Despite coiling, she developed near complete right ventricular outflow obstruction (based on echocardiography). She was successfully managed with a percutaneous right ventricle assist device, with subsequent resolution of the outflow obstruction.

Discussion

Septal haematomas with resultant outflow obstruction have been uniformly fatal. In our case, the use of a percutaneous right ventricle assist device was life-saving.

SUBMITTER: Doshi D

PROVIDER: S-EPMC6764583 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

A case report of right ventricular compression from a septal haematoma during retrograde coronary intervention to a chronic total occlusion.

Doshi Darshan D Hatem Raja R Masoumi Amirali A Karmapaliotis Dimitri D

European heart journal. Case reports 20190901 3

<h4>Background</h4>Septal haematomas causing left ventricular or biventricular outflow obstruction are rare but known complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can be life-threatening.<h4>Case summary</h4>In this case, we describe the formation of a septal haematoma during retrograde CTO PCI. The patient was initially managed conservatively but became progressively unstable, for which she underwent coiling of the inflow and outflow of the septal ...[more]

PMID: 31408099

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Project description:ObjectivesPatients with right ventricular (RV) infarctions associated with inferior infarctions have higher rates of adverse events than isolated inferior infarctions. Right atrial volume index (RAVI) has recently been described as a predictor of clinical outcome in patients with chronic systolic heart failure and pulmonary hypertension. The aim of this study is to assess the ability of RAVI to predict the persistent RV dysfunction after acute inferior STEMI due to occlusion of proximal RCA. To the best of our knowledge, this is the first study to investigate the relation between RAVI and persistent RV dysfunction in such group of patients.Patients and methodsSixty-five consecutive patients with recent first acute inferior STEMI who underwent primary percutaneous coronary intervention (PPCI) were prospectively included in the study. Echocardiographic evaluation was performed at the time of discharge and at 3 months. All the patients underwent standard echocardiographic assessment using conventional 2D and tissue Doppler imaging (TDI).ResultsPatients were divided into two groups according to right ventricular function (RVF) 3 months after acute myocardial infarction (AMI). The normal RVF group included 41 (63%) patients and the impaired RVF group included 24 (37%) patients. RAVI was significantly higher in patients with impaired RVF (p=<0.001). RAVI was a predictor of persistently impaired RV function (odds ratio = 1.786, 95% confidence interval, 1.367-2.335, p value= <0.001) and (odds ratio = 1.829, 95% confidence interval, 1.358-2.462, p value= <0.001) in univariate and multivariable logistic regression analyses respectively. In receiving operator characteristics (ROC) curve analysis, RAVI with a cutoff value ≥ 30 ml/m2 had a 87.5% sensitivity, a 92.24% specificity area under Receiving operator characteristics (ROC) curve = 0.964 for predicting persistently impaired RVF.ConclusionIn patients with inferior STEMI with proximal RCA occlusion, RAVI is an independent predictor of persistently impaired RVF with a cut-off value ≥ 30 ml/m2.

Dataset Information

A case report of right ventricular compression from a septal haematoma during retrograde coronary intervention to a chronic total occlusion.

Background

Case summary

Discussion

Publications

A case report of right ventricular compression from a septal haematoma during retrograde coronary intervention to a chronic total occlusion.

Similar Datasets

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