CTICasesIatrogenic Superior Vena Cava and Right Ventricular Perforation
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[...]. Iatrogenic Superior Vena Cava and Right Ventricular Perforation. CTICases. Published October 3, 2014. https://str-case-explorer.pages.dev/c/2fa2x
Imaging findings
Post-procedure chest radiograph demonstrates widening and abnormal opacity of the right supra-azygos mediastinum following pacemaker placement. Subsequent CT and intra-procedural angiography confirm a mediastinal hematoma, hemopericardium, and active extravasation of contrast from a perforation of the superior vena cava, with suspected right ventricular free wall perforation.
Key takeaways
Procedural complications during pacemaker lead placement, such as guide wire or lead perforation of the superior vena cava or right ventricle, must be suspected when new mediastinal widening or a pericardial effusion is seen post-operatively. Prompt surgical repair of the perforated sites is required.
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Related Devices & Post-op cases
- Cerebral Fat Embolism Post VSD Closure
- Atrioesophageal Fistula Post-Left Atrial Ablation
- Defibrillator Lead Insulation Disruption
- Pacemaker Lead Fracture (Thoracic Outlet Compression)
- LVAD-Induced Aortic Valve Stagnancy with Sinus of Valsalva Thrombus
- Right Ventricular Perforation and Pericardial Contrast Injection