title: Localized pericardial tamponade: does it always need exploration?
abstract: A 48-year-old female patient underwent coronary artery bypass surgery. One-hour after surgery, the patient developed hemodynamic instability. Transthoracic echocardiography (TTE) was inconclusive. Transesophageal echocardiography (TEE) was performed and it revealed localised collection around right atrium. In spite of the evidence of localized tamponade, wait and watch policy was employed rather than re-exploring the patient emergently. The patient recovered uneventfully. If hemodynamics remain stable and there is no fall in hematocrit and no increase in effusion on TEE/TTE examination, then localized tamponade can be managed conservatively without reexploring the patient.
authors.affiliation: Department of Cardiac Anesthesia, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Monish S
authors.initials: MS
authors.lastname: Raut
authors.forename: Arun
authors.initials: A
authors.lastname: Maheshwari
authors.forename: Ganesh
authors.initials: G
authors.lastname: Shivnani
mesh_terms: D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D020127:Recovery of Function; D057832:Watchful Waiting