title: A rare presentation of intrapericardial hematoma 20 months post aortic valve replacement.
abstract: We report the successful treatment of a rare case of chronic intrapericardial hematoma which presented with congestive cardiac failure 20 months after aortic valve replacement surgery for severe calcific aortic stenosis. Chest roentgenograph demonstrated paracardiac mass over lower left ventricle border, left pleural effusion and pulmonary venous hypertension. An echocardiographic study demonstrated intrapericardial mass posterolateral to left ventricle compressing left ventricular cavity both during systole and diastole causing septum to bulge into right ventricle. Computed tomography showed a loculated pericardial mass in left heart margin, left pleural effusion, bilateral axillary and mediastinal lymphadenopathy. Surgical resection was planned to relieve the symptoms and to confirm the diagnosis of the mass. The mass was completely resected through left anterolateral thoracotomy and histopathology findings confirmed the diagnosis of hematoma with cystic degeneration. Postoperative course was uneventful, and his symptoms improved markedly.
authors.affiliation: Senior Registrar, Department of Cardiology, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India. Electronic address: drsarjunbashaskm@gmail.com.
authors.forename: Khadhar Mohamed Sarjun
authors.initials: KM
authors.lastname: Basha
authors.affiliation: Registrar, Department of Cardiothoracic Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Vijayanand
authors.initials: V
authors.lastname: Palanisamy
authors.affiliation: Senior Consultant, Department of Cardiology, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Ezhilan
authors.initials: E
authors.lastname: Janakiraman
authors.affiliation: Senior Consultant, Department of Cardiothoracic Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Jacob
authors.initials: J
authors.lastname: Jamesraj
authors.affiliation: Consultant, Department of Cardiothoracic Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Pandian
authors.affiliation: Consultant, Department of Cardiothoracic Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Suresh Kumar
authors.initials: SK
authors.lastname: Sangili
authors.affiliation: Director, Department of Cardiology, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Mullasari
authors.initials: M
authors.lastname: Ajit Sankardas
mesh_terms: D001021:Aortic Valve / Q000473:pathology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002114:Calcinosis / Q000601:surgery*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Aortic valve replacement; Chronic expanding hematoma; Congestive cardiac failure