Successful Conservative Management of Right Ventricular Perforation Caused by Temporary Pacemaker Placement during Complex Percutaneous Coronary Intervention: A Case Report.

Cardiac tamponade is a critical condition that can result from complications during invasive cardiac procedures. This case report describes a 67-year-old male who developed right ventricular perforation leading to cardiac tamponade following elective complex percutaneous coronary intervention with rotational atherectomy and temporary pacemaker placement. By performing emergent pericardiocentesis and using a pigtail catheter with sustained negative pressure, we successfully managed a massive pericardial effusion of 2,600 cc. The patient stabilized without requiring surgical intervention, demonstrating favorable outcomes. This case underscores the importance of timely recognition and personalized management strategies in the conservative treatment of cardiac tamponade secondary to right ventricular perforation.