Biventricular transient systolic dysfunction after mitral valve replacement: Pericardial decompression syndrome

Abstract

HighlightsPericardial Decompression Syndrome is an unexpected clinical scenario with an incidence less than 5% in all surgically or percutaneously managed pericardial tamponade patients.Yet, in the majority of cases there is no obvious cause for the development of paradoxical ventricular dysfunction after decompression.Close postoperative monitoring for the first 24 h, preferably in the ICU, and aggressive heart failure treatments should be managed even if low cardiac output develops.We recommend gradual removal of pericardial effusion under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity

“…Two (2.8%) cases reported new-onset right to left shunt occurring after right ventricular failure. 5 7 8 9 10 11 12 14 15 16 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74…”

Pericardial decompression syndrome: A comprehensive review

“…Although judicious pericardial drainage may be potentially preventative against PDS, PDS may rarely develop even after small amount of pericardial drainage as previously documented in an isolated case report where patient developed PDS with pericardial fluid drainage of as little as 450 mL[29]. In general, the experts recommend stopping the initial drainage following the improvement of symptoms and hemodynamics followed by a slow gradual decompression through an indwelling pericardial catheter[4,27,30]. The slow gradual drainage may potentially allow a myocardial adaptation to the hemodynamic and filling pressure changes.…”