Search

The reuse of sterilized Inoue catheters is practiced widely in developing countries to bring down the procedure cost. However, blood can enter the space between the latex layers and become embedded in the mesh layer, which is difficult to clean when sterilizing the catheters. This is a common cause of rupture. Proper meticulous inspection of reused Inoue balloons for deformity or leakage through the small holes is necessary to prevent such complications.

Radial artery pseudoaneurysm is a very rare complication. In the presented case, computed tomography 3 months post percutaneous coronary intervention demonstrated contrast extravasation, suggestive of radial artery pseudoaneurysm. This complication was managed with thrombin infusion at the distal radial artery.

A 52-year-old woman presented to another hospital with progressive dyspnea of 10-day duration. The patient was diagnosed with a massive pericardial effusion and underwent pericardiocentesis. However, the patient's symptoms did not improve and she was referred to our hospital with a pericardial sheath in situ. On evaluation, the patient had a large pericardial effusion and evidence of cardiac tamponade, but no fluid could be aspirated from the sheath. This case underscores the importance of image-guided pericardiocentesis.

A 25-year-old man came to our clinic with the complaints of exertional palpitations and dyspnea. He had skeletal features suggestive of Marfan's syndrome. Contrast-enhanced computed tomography confirmed aneurysmal dilation of the aortic root and the proximal part of the ascending aorta. The patient was advised to undergo Bentall procedure for replacement of the aortic valve, aortic root, and ascending aorta. Marfan's syndrome is a connective tissue disorder with autosomal-dominant inheritance. Patients have a predisposition for progressive aortic root and ascending aortic dilation, and should undergo periodic echocardiographic monitoring.

During inflation of the Inoue balloon during a balloon mitral valvotomy, indentation and compression of the Inoue balloon was seen. This is indirect evidence of severe subvalvular disease.

Iatrogenic pneumopericardium after pericardiocentesis due to accidental leakage from the side port of the sheath has been reported in the literature. In the present case, it occurred during passage of the guidewire. Every step needs to be done meticulously. The patient should be advised not to take a deep breath during the puncture.