Laudinat J M, Chapoutot L, Metz D, Chabert J P, Metivet F, Taupin J M, Ehrhard V, Baehrel B, Elaerts J L, Bajolet A
Service de Cardiologie, CHU, Reims.
Ann Cardiol Angeiol (Paris). 1991 Mar;40(3):123-7.
The authors report 8 cases of hemopericardium compressing the left atrium occurring at varying intervals after cardiac surgery. This is an unusual anatomical and classically rare site of pericardial effusion. This type of tamponnade has special clinical features, leading to a picture of subacute left ventricular failure, by interference with filling and typical echocardiographic appearances, with special features in two-dimensional mode and, in TM mode, an abnormal anterior movement of the posterior wall of the left atrium, which is studied. CT scan of the thorax, when performed, confirms this highly specific topographic situation. This type of effusion must be managed surgically as quickly as possible, with an anterior approach, either by left thoracotomy or by midline sternotomy.
作者报告了8例心脏手术后不同时间出现的血心包压迫左心房的病例。这是一种不寻常的解剖位置,也是心包积液典型的罕见部位。这种类型的心脏压塞具有特殊的临床特征,通过干扰心脏充盈导致亚急性左心室衰竭的表现,以及典型的超声心动图表现,在二维模式下有特殊特征,在TM模式下,左心房后壁出现异常向前运动,对此进行了研究。胸部CT扫描(如果进行)可证实这种高度特异的局部情况。这种类型的积液必须尽快通过手术处理,采用前路,可通过左胸切开术或正中胸骨切开术。