title: Paradoxical hemodynamic collapse after subxiphoid pericardial window.
abstract: A 56-year-old man with a history of coronary artery disease, 4 months of cough and shortness of breath, a new lung mass, and increasing hypoxemia presented to the operating room emergently for a subxiphoid pericardial window for cardiac tamponade. After 1200 mL of pericardial fluid was drained, the patient immediately went into acutely decompensated right heart failure as seen on a transesophageal echocardiogram. The patient had cardiovascular collapse refractory to high-dose vasopressors, necessitating emergent venous-arterial extracorporeal membrane oxygenation for successful resuscitation.
authors.affiliation: From the Anesthesiology Department, Columbia University, New York, New York.
authors.forename: Benita T
authors.initials: BT
authors.lastname: Liao
authors.forename: Sansan S
authors.initials: SS
authors.lastname: Lo
mesh_terms: D002305:Cardiac Tamponade / Q000175:diagnosis / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010491:Pericardial Window Techniques / Q000009:adverse effects*; D020519:Pericardiocentesis / Q000379:methods; D012151:Resuscitation; D018497:Ventricular Dysfunction, Right / Q000209:etiology