Closing of a right ventricle perforation with a vascular closure device.

Vascular closure devices are a proven alternative to pure mechanical femoral compression after endovascular procedures. Their off-label use is uncommon and is usually restricted for atypical vascular sites-subclavian arteries and even descending aorta. We report for the first time a case of a successful percutaneous closure of a perforated right ventricle, using the Angio Seal femoral closure device. This was done after an attempt for pericardiocentesis in a high risk patient with carcinoma and cardiac tamponade, which was complicated with perforation of the right ventricle. The closure device successfully stopped the bleeding in the pericardium and spared the patient the need of open surgery and general anesthesia. A successful pericardial drainage was performed after this, and the patient was discharged with clinical improvement. Our literature review did not find descriptions of similar application of a vascular closure device. Our opinion is that such approach is effective and safe and may be used in some extreme and critical situations and in patients at high surgical risk. (c) 2009 Wiley-Liss, Inc.