Partial pericardial defect associated with ruptured aortic dissection of the ascending aorta: a rare feature presenting severe left hemothorax without cardiac tamponade

Nakajima, Masahiro; Tsuchiya, K; Naito, Yuji; Inoue, Hidenori; Kobayashi, Kensuke; Mizutani, Eiki

doi:10.1016/s0003-4975(03)01147-0

Cited by 11 publications

(7 citation statements)

References 8 publications

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“…Several studies have previously reported ruptured acute aortic dissection cases associated with a partial or complete congenital pericardial defect [2][3][4][5][6]. However, those cases involved little or no pericardial effusion with massive left hemothorax.…”

Section: Discussionmentioning

confidence: 99%

Relief of cardiac tamponade by a congenital partial left-sided pericardial defect in a patient with ruptured acute type A aortic dissection: a case report

et al. 2019

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Background: Acute type A aortic dissections have an extremely poor prognosis, and cardiac tamponade is a major cause of death in these patients. Here, we describe a case where congenital partial pericardial defect relieved cardiac tamponade caused by ruptured type A aortic dissection. Case presentation: A 79-year-old woman was hospitalized after experiencing chest pains and respiratory distress. She developed out-of-hospital cardiopulmonary arrest and was resuscitated with no sequelae 5 days before admission. Computed tomography confirmed pericardial and left pleural effusions, and type A aortic dissection was diagnosed. We began emergency ascending aortic replacement surgery under general anesthesia with propofol and remifentanil and incidentally discovered a congenital partial left-sided pericardial defect that allowed drainage of the hemopericardium and relieved cardiac tamponade. The surgery was successfully performed, and the patient recovered without complications. Conclusions: We experienced an extremely rare case where a congenital partial pericardial defect relieved cardiac tamponade associated with aortic dissection and contributed to the patient's survival.

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Section: Discussionmentioning

confidence: 99%

Relief of cardiac tamponade by a congenital partial left-sided pericardial defect in a patient with ruptured acute type A aortic dissection: a case report

et al. 2019

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“…PMCT initially exhibited a hematoma in the false lumen of the ascending aorta with a slight hemopericardium and a large amount of left hemothorax as well as focal pericardial dimpling and discontinuity around the left ventricle. Previous studies have described problematic conditions, such as a congenital pericardial defect associated with intrapericardial hemorrhage and a left hemothorax [12][13][14][15]. A congenital pericardial defect is usually found more frequently on the left side of the heart [25] and is characterized by a round to oval-shape with a smooth and thickened rim [26].…”

Section: Discussionmentioning

confidence: 99%

“…A hemothorax also occurs in some AoD cases, and most cases are considered to be the result of a rupture in the descending aorta [7][8][9]. Other cases have had an unusual presentation of a left pleural effusion complicated by AoD [10,11] or a congenital pericardial defect with ruptured type A AoD [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Pericardial tear as a consequence of cardiopulmonary resuscitation (CPR) involving chest compression: A report of two postmortem cases of acute type A aortic dissection with hemopericardium

et al. 2015

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“…There are only 6 reported cases, including our 2 cases, of congenital pericardial defect associated with ruptured acute type A dissection [1,[3][4][5]. The characteristics of these 6 cases are listed in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Congenital pericardial defect with ruptured acute type A aortic dissection

Furui

Ohashi

Hirai

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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We report 2 cases of congenital pericardial defect with ruptured acute type A aortic dissection. Case 1: An 83-year old man presented with sudden chest and back pain, and computed tomography (CT) showed acute aortic dissection with left pleural massive effusion. Because of his unstable haemodynamic condition with low blood pressure, an emergency operation was performed. We observed small amounts of bloody pericardial effusion, massive left-sided bloody pleural effusion and a partial left-sided pericardial defect of the pulmonary artery. The ascending aorta was replaced. The postoperative course was uneventful. Case 2: A 79-year old man presented with fainting followed by cardiac arrest and was resuscitated. Chest CT showed acute aortic dissection and massive haemothorax. Emergency operation was attempted, but was given up. We observed partial left-sided pericardial defect of the pulmonary artery. Further, we reviewed 6 cases of congenital pericardial defect with ruptured acute aortic dissection, including our 2 cases. In all the cases, the patients did not develop cardiac tamponade but had massive haemothorax due to congenital pericardial defects leading to confusion in diagnoses and surgical strategies. Therefore, it may be necessary to consider congenital pericardial defects before performing an operation in case of acute type A aortic dissection with massive haemothorax.

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Partial pericardial defect associated with ruptured aortic dissection of the ascending aorta: a rare feature presenting severe left hemothorax without cardiac tamponade

Cited by 11 publications

References 8 publications

Relief of cardiac tamponade by a congenital partial left-sided pericardial defect in a patient with ruptured acute type A aortic dissection: a case report

Relief of cardiac tamponade by a congenital partial left-sided pericardial defect in a patient with ruptured acute type A aortic dissection: a case report

Pericardial tear as a consequence of cardiopulmonary resuscitation (CPR) involving chest compression: A report of two postmortem cases of acute type A aortic dissection with hemopericardium

Congenital pericardial defect with ruptured acute type A aortic dissection

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