Cardiac

Case 67: Chest wall hematoma during pericardial drain placement

Contributed by Dr. Ram Gurajala
30 August 2020

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A patient in early 70’s presented to the clinic with type A and B acute aortic dissection. Underwent emergency surgical intervention where TEVAR was placed from the arch to the mesenteric segment of the aorta. The dissection extends to the common iliac arteries.

Post operative patient developed moderate pericardial effusion which was not amenable for drainage by the echo guidance. Request was made for the IR to perform the drain placement. We perform the procedure using ultrasound and CT guidance. During the initial attempts at needle placement, expansion of chest wall noted which on CT demonstrated a hematoma. IV contrast was given and a CTA performed to assess for any active bleeding. The following is as depicted in the images below…

 

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