Unusual treatment of postoperative bleeding after cardiac surgery

A young patient was presented to the emergency department with chest pain and palpitations. A transthoracic echocardiogram showed a right atrial mass. Coronary angiography showed a right coronary artery with collateral circulation to a large mass. The tumor could only be partially resected and the patient experienced persistent postoperative bleeding. We performed a new right coronary artery angiography which showed an important free extravasation of contrast into the pericardium through the collateral circulation. Using covered stents, the bleeding was controlled. The pathological examination performed later revealed a primary cardiac angiosarcoma. After asymptom-free survival of 14 months the patient presented bone metastases.