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- W3184262103 abstract "Coronary sinus (CS) perforation is a rare but potentially fatal complication during ablation procedures. Management may require emergent sternotomy and repair of the perforation to achieve hemostasis. To demonstrate the feasibility of managing CS perforation with covered stents. N/A A 70 year-old man (case #1) and a 79 year-old woman (case #2) both underwent radiofrequency ablation for persistent AF which included lateral mitral isthmus ablation with ethanol injection in the vein of Marshall. During CS contrast venography, contrast extravasation into the pericardial space was identified. Hemodynamically significant pericardial effusions were identified on ICE imaging. Pericardiocentesis with auto-transfusion of aspirated blood was performed. Despite protamine and administration of prothrombin concentrate complex, both patients continued to have bleeding and tamponade. Balloon-expandable stents (Gore VBX Stent Graft) were deployed in the main CS body (case #1) and the affected CS branch (case #2). Follow-up venography showed no extravasation. After stent placement, hemodynamic stability was achieved with no increase of effusion by ICE and decreased pericardial drain output. The pericardial drains were subsequently removed without re-accumulation of pericardial effusion after resuming anticoagulation. Both patients were discharged without further percutaneous or surgical intervention. These cases demonstrate the safety and feasibility of covered stent implantation in the CS for the management of cardiac tamponade after CS perforation. Covered stents may prevent the need for emergent sternotomy." @default.
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- W3184262103 date "2021-08-01" @default.
- W3184262103 modified "2023-09-25" @default.
- W3184262103 title "B-AB10-04 USE OF COVERED STENTS TO MANAGE CORONARY SINUS PERFORATION" @default.
- W3184262103 doi "https://doi.org/10.1016/j.hrthm.2021.06.061" @default.
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