Acute cardiovascular collapse after pericardial drainage in a patient with aortic dissection.
Proximal aortic dissection is frequently associated with cardiac tamponade. The treatment sometimes is difficult. We present a 69-year-old female patient who after repeated episodes of syncope received an open drainage of pericardial effusion that ended in a fatal outcome. She was also known to have mural thrombi in the aorta. However, preanesthetic trransesophageal echocardiography revealed besides pericardial effusion, also dilatation of aortic root which compressed both atria. She developed sudden cardiovascular collapse following drainage of pericardial effusion to which she succumbed in spite of vigorous resuscitation. We suggest that the patients with cardiac tamponade complicated by aortic dissection must receive direct aortic repair together with intraoperative pericardial drainage. Selective or single pericardiocentesis should better be avoided.
Huang
Chi-Hsiang
CH
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Chang
Yi
Y
Chan
Wing-Sum
WS
Chao
Anne
A
Huang
Hui-Hsun
HH
Wu
Gong-Jhe
GJ
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000150:complications*; D001014:Aortic Aneurysm / Q000150:complications*; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000150:complications; D006801:Humans; D010490:Pericardial Effusion / Q000628:therapy*