title: [Pericardial Fenestration in a Patient with Myocardial Metastasis and Cardiac Tamponade after Surgery for Esophageal Cancer;Report of a Case].
abstract: We report a case of pericardial fenestration in a patient with myocardial metastasis and cardiac tamponade after surgery for esophageal cancer. A 66-year-old man had been suffering from orthopnea, hypotension and general malaise due to cardiac tamponade and heart failure. Esophagectomy was performed with substernal gastric tube reconstruction for advanced esophageal carcinoma. Nine months after the operation, heart failure developed, and myocardial and pericardial metastasis was subsequently detected. Subxiphoidal pericardiocentesis was abandoned due to the substernal gastric tube, and pericardial fenestration was performed through a small left anterior thoracotomy at the 5th intercostal space. His symptoms were ameliorated immediately and the procedure contributed greatly to maintain his quality of life. Preoperative computed tomography was useful for revealing the anatomical positions of the gastric tube and important vessels.
authors: Department of Cardiovascular Surgery, Heart Center, Ikegami General Hospital, Tokyo, Japan.
authors: Kensuke
authors: K
authors: Kobayashi
authors: Yukio
authors: Y
authors: Suto
authors: Okihiko
authors: O
authors: Akashi
authors: Yoshihito
authors: Y
authors: Sakata
authors: Yasufumi
authors: Y
authors: Hayama
authors: Junichi
authors: J
authors: Kon
authors: Osamu
authors: O
authors: Chino
mesh_terms: D000368:Aged; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery*; D004452:Echocardiography; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008297:Male; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed