title: Myocardial Ischemia Caused by Subepicardial Hematoma.
abstract: BackgroundBleeding from bypass anastomosis leakage occurs early after coronary artery bypass grafting. Later, once the anastomosis is covered by intima, spontaneous bleeding is unlikely.Case DescriptionA 63-year-old male patient developed a pseudoaneurysm-like, subepicardial late-term bleeding resulting in a hematoma that compromised coronary artery flow by increasing extracoronary pressure. This resulted in severe angina pectoris (Canadian Cardiovascular Society IV) and myocardial ischemia within the affected area. After surgical removal of the hematoma and repair of the anastomosis, the patient's symptoms disappeared and no signs of myocardial ischemia were present.ConclusionSurgical removal is an efficient therapy for subepicardial hematoma inducing myocardial ischemia.
authors.affiliation: Department of Adult and Pediatric Cardiovascular Surgery, University Hospital of Giessen, Giessen, Germany.
authors.forename: Philippe
authors.initials: P
authors.lastname: Grieshaber
authors.affiliation: Department of Cardiology and Angiology, University Hospital of Giessen, Giessen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.affiliation: Department of Adult and Pediatric Cardiovascular Surgery, University Hospital of Giessen, Giessen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Böning
authors.affiliation: Department of Adult and Pediatric Cardiovascular Surgery, University Hospital of Giessen, Giessen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Niemann
keywords: CABG; complication; coronary artery bypass grafting; hematoma; myocardial ischemia