ArticleCureus2025
Iatrogenic Right Ventricular Perforation Following an Endomyocardial Biopsy for Fulminant Myocarditis.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Right ventricular (RV) perforation is a rare but potentially life-threatening complication of endomyocardial biopsy (EMB), particularly in patients with fulminant myocarditis, where myocardial edema increases myocardial fragility. We describe the case of a 50-year-old woman who developed acute RV free-wall perforation immediately after EMB performed for suspected fulminant myocarditis. Emergent pericardial drainage temporarily stabilized her hemodynamics, but ongoing hemorrhage necessitated urgent conversion to open surgical repair. A 3-mm perforation on the anterior RV wall was successfully sealed using a fibrin patch (TachoSil®) and a collagen-based hemostatic agent (Bolheal®), followed by extracorporeal membrane oxygenation support for circulatory stabilization. The patient recovered completely without recurrence and remained stable at the 10-month follow-up. This case highlights the need for early recognition of biopsy-related perforation, prompt surgical preparedness, and meticulous septal targeting during EMB, particularly in patients with myocarditis whose edematous myocardium is highly susceptible to mechanical injury.
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