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European Journal of Echocardiography 2006 7(5):390-393; doi:10.1016/j.euje.2005.07.009
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Copyright © 2005, The European Society of Cardiology

Iatrogenic aortic haematoma during primary PTCA: Diagnostic value of transesophageal echocardiography in cath lab

Fabio Minicucci, Gianluigi Galizia, Luigi Ascione*, Gianluca Granata, Anna Scaglione, Maria Accadia, Salvatore Rumolo and Bernardino Tuccillo

Department of Cardiology, "S. Maria di Loreto" Hospital, Viale dei Pini 4, 80055 Portici (NA), Italy

Received 9 April 2005; received in revised form 10 July 2005; accepted after revision 27 July 2005.

* Corresponding author. Tel.: +39 817755064; fax: +39 812542752. luigi.ascione20{at}tin.it


  Abstract

A 60-year-old woman with severe chest pain and ECG diagnostic for acute transmural ischemia was transferred to cath lab for primary PTCA. After procedure, transesophageal echocardiography (TEE) views revealed an intramural haematoma extending from the ostium of the RCA throughout the sino-tubular junction. These findings and the stable clinical conditions of patient guided us to a conservative therapeutic approach. A TEE study, performed 5 days after admission, showed a complete resolution of intramural haematoma. A waiting strategy can be a valid therapeutic option in selected patients with iatrogenic haematoma and TEE is a useful diagnostic tool for clinical decision making.

Keywords: Intramural haematoma; Transesophageal echocardiography


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