[Incidence, clinical aspects and therapy of late pericardial tamponade following heart surgery].
Late cardiac tamponade is a very severe condition that presents with subtle signs and symptoms within days or weeks after cardiac surgery. In a consecutive series of 3782 patients, 33 developed this complication, mostly due to overdosage of anticoagulants or to unsafe combination of 2 anticoagulation regimen. Diagnosis can be difficult and is best confirmed by echocardiography; in patients with primary uneventful recovery and sudden cardiocirculatory deterioration, intensive work-up should be performed to exclude or confirm the suspicion of late pericardial tamponade. The treatment of late pericardial tamponade should not be delayed and consists in subxyphoidal drainage. Re-sternotomy might be necessary to assume complete decompression of the heart in case of well-localized and posterior tamponade and/or organized pericardial fluid. Since this complication can happen in any patient transferred to peripheral hospital for postoperative recovery after cardiac surgery, we believe that this complication should be recognized very early and should be treated, in case of necessity, by general surgeons. Usually, no active bleeding is found at revision.
Wilhelm
M
M
Klinik für Herz- und Gefässchirurgie, Universitätsspital Zürich.
Carrel
T
T
Jenni
R
R
Turina
M
M
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D002305:Cardiac Tamponade / Q000209:etiology* / Q000628:therapy*; D004322:Drainage; D005260:Female; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000150:complications; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy*; D012086:Reoperation
D000925:Anticoagulants
Inzidenz, Klinik und Therapie der verzögerten Perikardtamponade nach herzchirurgischen Eingriffen.