Clinical analysis of pericardial effusion and cardiac tamponade complicating percutaneous coronary intervention

Objective The purpose of this study was to characterize the incidence, relative factors, management and clinical outcome of pericardial effusion and cardiac tamponade associated with percutaneous coronary intervention (PCI). Methods A successive database of 1 246 PCI, including medical, operation, and nursing record were analyzed to determine etiological factors, diagnosis time, clinical situation, management method and outcome of pericardial effusion and cardiac tamponade. Results There were 8 patients (0 64%) with pericardial effusion and 3 patients (0 24%) with cardiac tamponade in 1 246 PCI procedures. Ten patients (91%) were diagnosed in catheterization laboratory and 1 patient (9%) was diagnosed late. There were 9 cases of coronary perforation (81 8%) caused by guide wire or balloon by coronary artery angiography in patients with chronic total occulsion (CTO), including balloon across coronary artery without dilatation in 2 patients, with dilatation in 1 patient. Two cases of right ventricular perforation (18 2%) caused by pacing leads were determinated by echocardiogram and clinical manifestation in myocardial infarction patients. Pericardiocentesis was performed in 3 cases of cardiac tamponade. Conclusion Coronary and right ventricular perforation are main causes of pericardial effusion/cardiac temponade in PCI. Most pericardial effusion cases were observed in CTO patients, but more cardiac tamponade in MI patients. Correct technique and reasonable devices might reduce the incidence. The diagnosis of coronary perforation is easier than that of right ventricular perforation. Most coronary perforation can be diagnosed early in catheterization laboratory and can be treated reasonablely.