{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T03:24:47Z","timestamp":1778729087183,"version":"3.51.4"},"reference-count":3,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Injury of the great cardiac vein (GCV) during circumflex coronary artery intervention is not discussed enough in the literature. In addition, relationship between the GCV and circumflex artery is highly variable and practically unpredictable in 30% of cases. This report describes a rare case of GCV injury during circumflex artery intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>An 80-year-old man with known ischaemic heart disease was admitted with unstable anginal pain for urgent coronary angiography. Circumflex (Cx) percutaneous coronary intervention (PCI) of proximal-to-medial high-grade calcified stenosis was performed. Two hours later, the patient developed pericardial tamponade. Pericardiocentesis revealed a venous bloody effusion. Due to continuous bleeding, an urgent exploratory thoracotomy was performed. Intraoperatively, a large pericardial haematoma in the Cx region was evacuated. The perforation site was sought and identified as a tear at the GCV. Further hospitalization was uneventful, and the patient was discharged after one week. Clinical and echocardiographic outcomes were favourable at the 3-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>A GCV injury during PCI is a diagnosis of exclusion if there is a venous pericardial effusion directly after PCI and no injury of the right ventricle or surrounding structures, and thoracic computed tomography demonstrates a pericardial haematoma in the PCI region, especially the Cx region. A haematoma can deteriorate the haemodynamic status without effusion \u2018dry tamponade\u2019. Treatment should be addressed according to haemodynamics. A conservative therapy, pericardiocentesis, catheter-based bailout intervention or even an explorative pericardiotomy could be imperative to evacuate the haematoma and seal the injured vein.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad335","type":"journal-article","created":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T00:04:25Z","timestamp":1689984265000},"source":"Crossref","is-referenced-by-count":2,"title":["Great cardiac vein injury after circumflex artery intervention: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-4167","authenticated-orcid":false,"given":"Abdelrahman","family":"Elhakim","sequence":"first","affiliation":[{"name":"Cardiology Department, Interventional Cardiology, Schoen Hospital Neustadt , Am Kiebitzberg 10, 23730 Neustadt in Holstein , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4533-160X","authenticated-orcid":false,"given":"Mohamed","family":"Elhakim","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Critical Care and Anesthesia, Nepean Hospital , Derby Street, Kingswood, 2747 Sydney, NSW , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Ismail","sequence":"additional","affiliation":[{"name":"Cardiology Department, Interventional Cardiology, University Clinic Oldenburg , Rafel-Straus-Strasse 10, 26133 Oldenburg , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-3706","authenticated-orcid":false,"given":"Mohammed","family":"Saad","sequence":"additional","affiliation":[{"name":"Cardiology Department, Interventional Cardiology, Schleswig-Holstein University Hospital-Kiel , Arnold-Heller-Street 3, 24105 Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"2023081904434186600_ytad335-B1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.amjcard.2003.09.042","article-title":"Incidence, predictors, in-hospital, and late outcomes of coronary artery perforations","volume":"93","author":"Stankovic","year":"2004","journal-title":"Am J Cardiol"},{"key":"2023081904434186600_ytad335-B2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/BF01628039","article-title":"The great cardiac vein","volume":"14","author":"Pejkovic","year":"1992","journal-title":"Surg Radiol Anat"},{"key":"2023081904434186600_ytad335-B3","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1148\/rg.321115014","article-title":"Coronary veins: comprehensive CT-anatomic classification and review of variants and clinical implications","volume":"32","author":"Saremi","year":"2012","journal-title":"Radiographics"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytad335\/50929749\/ytad335.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/8\/ytad335\/51172811\/ytad335.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/8\/ytad335\/51172811\/ytad335.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T04:44:12Z","timestamp":1692420252000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytad335\/7227897"}},"subtitle":[],"editor":[{"given":"Grigoris","family":"Karamasis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nidhi","family":"Madan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Hikmet","family":"Kadioglu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,7,21]]},"references-count":3,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytad335","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,7,21]]},"article-number":"ytad335"}}