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The account alleges that during a pulmonary vein isolation procedure with the patient under sedation with propofol a tamponade occurred requiring thoracic surgery due to a non-merit guidewire.After successful transseptal puncture, the left superior and inferior pulmonary vein were isolated.After deflating and retracting the balloon catheter from the left inferior pulmonary vein, there was a drop in blood pressure.A transthoracic echography revealed accumulating pericardial blood.With a pericardial puncture >750ml of blood was withdrawn and it was decided to do emergency thoracic surgery.This revealed a 2 cm antero-superior tear of the left inferior pulmonary vein.The tear was sutured and the patient stabilized.The patient was moved to the icu for further observation.It is alleged that while switching to the left inferior pulmonary vein, the guidewire protruded out of the balloon catheter causing a tear.This was not noticed at first and the guidewire was advanced in the direction of the left inferior pulmonary vein.The balloon was then advanced and inflated.After deflating, the balloon no longer blocked the tear and the tamponade was then noted.The physician alleges the event was due to the guidewire and not the catheter.
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