Taguchi Shingo, Hachiya Takashi, Onoguchi Katsuhisa, Hanai Makoto, Sumi Makoto, Yamazaki Masataka, Yamashiro Masahito
Department of Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.
Kyobu Geka. 2016 Dec;69(13):1102-1105.
We report a rare case of cardiac failure for intrapericardial hematoma 11 years after coronary artery bypass grafting. A 59-year-old man was admitted to our hospital with cardiac tamponade. Echocardiography and computed tomography scan showed severe compression of the left ventricle(LV) by a large mass sized about 5×8 cm. Coronary angiography showed total occlusion at circumflex branch (Cx) #11. The mass was diagnosed with intrapericardial hematoma. We performed removal of hematoma in the pericardial cavity, and removed hematoma had 126 g. Considering that the patient had suffered from diabetes mellitus, the localized collection of the hematoma might be explained by possible slow oozing from LV free wall rupture after asymptomatic myocardial infarction at Cx area.
我们报告一例冠状动脉搭桥术后11年发生心包内血肿导致心力衰竭的罕见病例。一名59岁男性因心脏压塞入住我院。超声心动图和计算机断层扫描显示左心室(LV)被一个大小约为5×8 cm的巨大肿块严重压迫。冠状动脉造影显示回旋支(Cx)#11完全闭塞。该肿块被诊断为心包内血肿。我们进行了心包腔内血肿清除术,清除的血肿重达126 g。考虑到患者患有糖尿病,血肿的局部积聚可能是由于Cx区域无症状心肌梗死后左心室游离壁破裂可能出现的缓慢渗血所致。