Author + information
- Received October 27, 2015
- Revision received December 4, 2015
- Accepted December 10, 2015
- Published online June 1, 2016.
- Parasuram Krishnamoorthy, MDa,
- Mark L. Shapiro, MDb,
- Dmitry Nemirovsky, MDc,
- David Y. Feigenblum, MD, PhDc and
- Grant R. Simons, MDc,∗ ()
- aDepartment of Cardiology, Einstein Heart and Vascular Center, Albert Einstein Medical Center, Philadelphia, Pennsylvania
- bDepartment of Radiology, Englewood Hospital and Medical Center, Englewood, New Jersey
- cDepartment of Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey
- ↵∗Reprint requests and correspondence:
Dr. Grant R. Simons, Arrhythmia Center, 5 East, Englewood Hospital and Medical Center, 350 Engle Street, Englewood, New Jersey 07631.
Radiofrequency catheter ablation of atrial fibrillation carries a risk of thermal damage to extracardiac structures, including the esophagus and the phrenic nerves (1–3); however, aortic complications have not been described previously. We report a case of aortic intramural hematoma in a 68-year-old Asian woman after radiofrequency catheter pulmonary vein isolation. A pre-procedure computed tomography scan showed no aortic abnormalities. Posterior encirclement lesions were at 20 W for 15 s. A computed tomography scan for abdominal pain on post-procedure day 6 revealed Stanford type B intramural aortic hematoma with intact intima originating at the level of the left subclavian artery (Figures 1 and 2) extending throughout the thoracic aorta and visualized abdominal aorta (L2/3); there was a thrombosed false lumen throughout the entire length (Figure 3). Importantly, the left inferior pulmonary vein antrum was adjacent to the aorta (Figure 2), hence raising a suspicion that thermal damage from the procedure was etiologic, synergistic with periprocedural anticoagulation.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 27, 2015.
- Revision received December 4, 2015.
- Accepted December 10, 2015.
- American College of Cardiology Foundation
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