Case report: successful retrieval of an entrapped balloon during balloon pericardiotomy after rupturing

Balloon rupture and entrapment during percutaneous balloon pericardiotomy (PBP) is rare and usually requires surgical intervention. However, various bailout techniques can be tried. We describe a case of balloon entrapment in the pericardium and the strategies employed to successfully remove the balloon percutaneously.

A 58-year-old woman presented with recurrent malignant pericardial effusion. She refused surgery and opted for PBP. During the procedure, the balloon ruptured and was trapped within the pericardium. The entrapped balloon was secured by snaring onto the proximal end of the balloon. The distal end of the balloon remained trapped across the pericardium as it did not deflate completely after rupturing. Therefore, a needle was inserted under fluoroscopic guidance to decompress the balloon, which enabled its successful removal percutaneously.

This is the first reported case of balloon rupture and entrapment during PBP that was successfully removed percutaneously. When balloon rupture and entrapment occur, retrieval can be attempted by using forceps and snares.