It was reported that during a cryo ablation procedure, when the transseptal puncture was performed the guidewire went through the septum on its own.The ablations were completed for the left pulmonary veins (left superior pulmonary vein (lspv) and left inferior pulmonary vein (lipv).Then the transseptal access was lost while attempting to maneuver from the left pulmonary veins to the right pulmonary veins.After several attempts to regain transseptal access, a pericardial effusion occurred in the right atrium.A pericardiocentesis was performed to remove a significant quantity of blood from the right side of the heart.The case was aborted while the patient was under general anesthesia.The patient required extended hospitalization.It was noted before the case that the patient had a "quite unusual heart anatomy where the septum was thin" and it was difficult to visualize with transesophageal echocardiogram (tee).It was also reported that the guidewire kinked during the procedure and was replaced twice with another manufacturer's product.It was surmised that the tip of the dilator/needle my have injured the inner layer of the right side heart during manipulation.It was further reported that the patient is doing well and will be discharged from the hospital.No further patient complications have been reported as a result of this event.
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