Cardiac tamponade complicating closure of a median sternotomy.
A case of intraoperative cardiac tamponade manifested during closure of a median sternotomy is presented. We postulate that cardiac tamponade was caused by acute dilatation of the cardiac chambers as a result of intraoartic balloon pumping in a patient with aortic and mitral regurgitation. It has been shown experimentally that acute rises in ventricular end-diastolic pressure result in increased intrapericardial pressure and that if a certain point on the pericardial pressure-volume curve is reached, cardiac tamponade will occur. Sternotomy closure was accomplished easily as soon as the need for intra-aortic balloon pumping diminished.
D001022:Aortic Valve Insufficiency / Q000150:complications; D001243:Assisted Circulation / Q000009:adverse effects*; D002305:Cardiac Tamponade / Q000209:etiology*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications; D004108:Dilatation, Pathologic; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications; D013249:Sternum / Q000601:surgery*