Experience with cardiac tamponade following open heart surgery

Abstract

Cardiac tamponade following open heart surgery is well described, although, fortunately, uncommon. Unlike more classical "primary" tamponade, the clinical features are not specific, and this can delay diagnosis. In practice, the threshold for investigation must be low, and echocardiography has been invaluable in the detection and localization of pericardial collections. Several factors are believed to contribute to the likelihood of postoperative tamponade, but the mechanisms are not clearly understood. Resternotomy, under general anesthesia, or subxiphoid pericardiotomy, under local or general anesthesia, are effective forms of treatment. However, recent success with the use of percutaneous pericardiocentesis under echocardiographic guidance has shown that postoperative tamponade can be treated safely and effectively by this method.

Endoscopic treatment for delayed cardiac tamponade

“…Early diagnosis and immediate treatment of this disease are usually followed by an immediate relief of symptoms [4].…”

Incidence and factors associated with pericardial effusion after cardiac valve surgery

“…This finding has already demonstrated to be an important risk factor for PE 3,12 , which may be related to changes in coagulation parameters during these periods. We did not find differences in the types of cardiac valve replacement and the type of prosthesis (mechanic or biologic).…”

“…Aspirin reduces the risk of death and ischemic complications 12 after coronary artery bypass grafting, but it is associated with a higher risk of postoperative PE 3,17 . In our analysis, patients with moderate-to-severe PE used less aspirin and had a similar use of anticoagulants compared to absent or small PE patients.…”

Diagnosis and management of cardiac tamponade in the era of echocardiography

“…Minor complications include transient chamber entry, vasovagal response, pneumoperic&um, brief ventricular arrhythnua, and small spontaneously resolving pneumothorax. 42 Special considerations are warranted in some conditions. Malignant pericardial effusions are generally associated with a poor prognosis.…”