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“The Pericardial Effusion is Drained, But the Catheter Is Stuck”—Percutaneous Evacuation of Pericardial Effusion Complicated by Pigtail Catheter Entrapment in Fibrinous Pericarditis

Published:March 26, 2022DOI:https://doi.org/10.1053/j.jvca.2022.03.024
      PERICARDIOCENTESIS HAS been demonstrated to be a safe and valuable tool in the treatment of patients with moderate-to-large pericardial effusions or cardiac tamponade.
      • Tsang TS
      • Enriquez-Sarano M
      • Freeman WK
      • et al.
      Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: Clinical profile, practice patterns, and outcomes spanning 21 years.
      Major complications are rare, but can include death, cardiac arrest, and iatrogenic perforation of the heart or vascular structures.
      • Kumar R
      • Sinha A
      • Lin MJ
      • et al.
      Complications of pericardiocentesis: A clinical synopsis.
      Minor complications including hypotension and non-life-threatening arrhythmias are more common, but infrequent. The majority of complications are reported at the time of catheter placement; there are few reported complications during removal of the catheter. The authors present the case of a pericardiocentesis drainage catheter that was unable to be removed using gentle traction at the bedside or in the cardiac catheterization laboratory under fluoroscopic guidance; surgical intervention including sternotomy and cardiopulmonary bypass were required to remove the catheter safely. The catheter was noted to be wrapped around the heart, and the proximal portion of the catheter was revealed to be trapped in dense fibrinous inflammatory tissue on the anterior surface of the heart.

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