Late posterior cardiac tamponade after open heart surgery
Journal of Cardiovascular Surgery, cilt.37, sa.6, ss.615-620, 1996 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 37 Sayı: 6
- Basım Tarihi: 1996
- Dergi Adı: Journal of Cardiovascular Surgery
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.615-620
- Anahtar Kelimeler: cardiac tamponade, pericardiocentesis, echocardiography, open heart surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective. Late cardiac tamponade after open heart surgery is a relatively uncommon, but potentially serious complication. We retrospectively analyzed 14 patients who had posterior cardiac tamponade 13 to 210 days after open heart surgery. Patients. Between May 1988 and July 1995, 3150 adult patients underwent open heart surgery at the Gulhane Military Medical Academy. In 35 of 3150 patients (1.11%) late pericardial effusions developed, and in 14 (0.44% of 3150 consecutive open heart surgery performed on adult patients in our center) of these patients had posterior tamponade. There were moderate symptoms including fatigue, malaise, and dyspnea on exertion in all patients. The diagnosis was made by echocardiography in 13 patients, and by tomographic scanning in 1 patient. Analysis of these 14 patients revealed that all of them had hemodynamic criteria consistent with tamponade physiology on right heart catheterization with Swan-Ganz catheters. Results. Echocardiography guided pericardiocentesis through the left anterior axillary line was effective in decompressing of posterior cardiac tamponade in 10 of 14 patients. Three patients required operative surgical drainage after unsuccessful pericardiocentesis through subxiphoid area. Two patients who underwent surgical drainage died, and in one patient surgical pericardiotomy had complete evacuation of posterior pericardial fluid with major complication. Conclusions. 2-D echocardiography guided pericardiocentesis through left anterior axillary line was found to be a useful, safe, and simple technique. It can be used as an alternative treatment to surgical pericardiotomy for posterior cardiac tamponade after open heart surgery.