traumatic experience with a patient a few years ago that still left me with a bad feeling. It was a hit-and-miss instance, and the fact that it was so, more closely being miss than hit, has stayed with me ever since. It was the first time that I ever came so breathtakingly close to being implicated in causing another to die. I hope it will be the last. As to the lessons that it can teach me -- there are several.

The story was the following: It was one fine, not especially busy Saturday morning when this patient was wheeled in for a percutaneous transfemoral aortic valve implantation. While the cardiology team was inserting the femoral guide wires and sheath for valve placement the ventricle was perforated. Usually we have more time and can proceed more placidly, but in this particular case, we had to rapidly respond and open the...
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