title: Pericardiocutaneous fistula: presentation with acute hemorrhage 8 years following aortic valve replacement.
abstract: Pericardiocutaneous fistula is a rare complication of cardiac surgery. A 35-year-old female presented with acute severe hemorrhage from a pericardiocutaneous fistula eight years following aortic valve replacement. Computed tomography showed a large, pericardial collection causing tamponade, connected to a smaller subcutaneous cavity, with a tract leading to the skin. The patient underwent emergency surgical exploration with removal of hematoma, hemostasis, and partial pericardectomy. One year following the operation, the patient remains stable. Factors in the development of pericardiocutaneous fistula were valve replacement, infection, and warfarin anticoagulation.
authors.affiliation: Department of Cardiac, Vascular and Thoracic Surgery, Royal Victoria Hospital, Grosvenor Rd, Belfast BT12 6BA, UK.
authors.forename: R P
authors.initials: RP
authors.lastname: De Freitas
authors.forename: J Mark
authors.initials: JM
authors.lastname: Jones
authors.forename: D J
authors.initials: DJ
authors.lastname: Gladstone
authors.forename: J A
authors.initials: JA
authors.lastname: McGuigan
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery; D002305:Cardiac Tamponade / Q000209:etiology* / Q000601:surgery; D002908:Chronic Disease; D017577:Cutaneous Fistula / Q000209:etiology* / Q000601:surgery; D005260:Female; D006331:Heart Diseases / Q000209:etiology* / Q000601:surgery; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010496:Pericardium