An abnormal left ventricular-atrial perforation after radiofrequency catheter ablation: a case report
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(2019) 14:185
CASE REPORT
Open Access
An abnormal left ventricular-atrial perforation after radiofrequency catheter ablation: a case report Tingting Tao, Junnan Zheng, Hongfei Xu and Yiming Ni*
Abstract Background: Cardiac radiofrequency ablation is a popular treatment for arrhythmias. However, it does have some complications, some of which are severe, even fatally. And there were limited reports on cardiac internal perforation after radiofrequency catheter ablation (RFCA) that required a surgical repair. Case presentation: A 47-year-old male was admitted to our hospital due to chest congestion for 4 months. He received a radiofrequency catheter ablation (RFCA) 9 months prior to admission. On admission, an echocardiogram showed an abnormal perforation between the left ventricle and the left atrium with moderate mitral valve regurgitation. We therefore performed a mitral valve replacement (MVR) and fixed the abnormal atrial-ventricular breakage via median sternotomy. Conclusions: Cardiac perforation is a severe complication of cardiac RFCA, operators should be extremely cautious to minimize radiofrequency associated perforations. Such a challenging and complex procedure should be deliberately considered by doctors and patients before implementation. Keywords: Cardiac perforation, radiofrequency catheter ablation, complication
Background Cardiac radiofrequency ablation is a popular treatment for arrhythmias, and is said to have a very high success rate [1, 2]. Although, the method is proved to be feasible and effective in treating atrial fibrillation (AF) and other arrhythmia [3]. However, it does have some complications [1], some of which are severe, even fatally. But there were limited reports on cardiac internal perforation after radiofrequency catheter ablation (RFCA) that required a surgical repair [3]. Here we report a male patient with an abnormal left atrium-ventricle perforation after RFCA as well as moderate mitral valve regurgitation. We performed an open heart surgery and fixed the perforation. Case presentation A 47-year-old male was admitted to our hospital due to chest congestion for 4 months. Nine months prior to * Correspondence: [email protected] Department of Cardiothoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, 79#, Qingchun Road, Zhejiang 310000, Hangzhou, China
admission, the patient received a radiofrequency catheter ablation (RFCA) in local hospital due to paroxysmal supraventricular tachycardia (PSVT). The surgery was reported successful. However, the patient began to experience recurrent chest discomfort 5 months after the surgery. On admission, an echocardiogram showed an abnormal perforation between the left ventricle and the left atrium with moderate mitral valve regurgitation (Fig. 1a). And the CT scan depicted nothing abnormal of the heart but only bronchopneumonia in the right lung (Fig. 1b). After completing relevant examinations and excluding obvious contraindication of operation, we performed a mitral valve replacement (MVR) and fixed
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