Percutaneous Treatment of Right Ventricular Rupture with ADO II device via the Subxiphoid Pericardial Window; After Percutaneous Treatment of Cardiac Tamponade.

Pericardiocentesis (PC) is essentially a diagnostic and potential life-saving therapeutic procedure. Currently, echocardiography-guided and fluoroscopic-guided PC are considered the standard clinical practice in the treatment of large pericardial effusions and cardiac tamponade (1). The morbidity rate is approximately 1–3% and the mortality rate due to injuries directly caused by the procedure is less than 1% (2). Although considered relatively safe, this invasive procedure may be associated with certain risks and potential serious complications such as mortality, cardiac arrest, pericardial/epicardial thrombus, cardiac chamber laceration requiring surgery, injury to an intercostal vessel, pneumothorax requiring chest tube placement, ventricular tachycardia, pulmonary oedema, local/systemic infection, and cardiac perforation leading to tamponade (1). The cardiac perforation rate is approximately 1% (1). Although cardiac perforation patients are primarily treated by surgical repair, percutaneous treatment is another alternative for patients with extreme tenuous hemodynamic parameters and multiple comorbidities as in our case (3). We report a case of right ventricle (RV) apical wall rupture that occurred during PC, which was successfully repaired percutaneously using AMPLATZER ductal occluder type II (ADO II) (St. Jude Medical, St. Paul, Minnesota, US) devices via subxiphoid pericardial window.