Delayed fatal cardiac perforation by an indwelling long introducer sheath following transjugular intrahepatic portocaval stents (TIPS).

Iatrogenic cardiac perforation is a recognized complication of central venous catheterization. We report a fatal complication by a 10F introducer sheath which was left in place and resulted in perforation of the right atrial wall 8 h later. This case is reported to emphasize the increased risk of cardiac perforation from large caliber rigid sheaths which should be withdrawn immediately after completion of the procedure.