Center for Preclinical Surgical and Interventional Research, Texas Heart Institute, Houston, Texas, USA.
Department of Cardiovascular Pathology, Texas Heart Institute, Houston, Texas, USA.
Vet Med Sci. 2022 Sep;8(5):1965-1968. doi: 10.1002/vms3.892. Epub 2022 Aug 3.
Delayed cardiac tamponade, a life-threatening complication of pericardial effusion in humans, has rarely been described in large animal models. We report here a pig with cardiac tamponade that developed 29 days after cardiac surgery.
Case report.
One 45-kg domestic pig.
Open-chest surgery was performed on a pig to induce chronic heart failure. At 15 days after surgery, the pig's breathing appeared laboured; induced heart failure was considered the cause. Routine heart failure medications were administered.
On day 28, the pig's status deteriorated. On day 29, echocardiography performed just before the pig's death showed a large pericardial effusion, mainly in the lateral and anterior walls of the right heart, with several fibre exudation bands. The right heart was severely compressed with an extremely small right ventricle. An emergency sternotomy was unsuccessful. Pathologic examination showed a severely thickened, fibrous pericardium. The pericardial sac was distended (up to 4.5 cm) and was full of dark brown, soft, friable material. Epicardial haemorrhage with a fresh, organised thrombus was noted in the pericardium.
Delayed tamponade occurring at least 15 days after open-chest surgery is easy to misdiagnose or overlook in large animal models where attention is often focused on primary pathological model changes. To decrease mortality in animal models, researchers should be aware of potential complications and use the same level of follow-up monitoring of large animals as in clinical care.
心包积液导致的心包填塞是人类的一种危及生命的并发症，但在大型动物模型中很少有报道。我们在此报告一例心脏手术后 29 天发生心包填塞的猪。
病例报告。
一只 45 公斤的家猪。
对猪进行开胸手术以诱导慢性心力衰竭。手术后 15 天，猪的呼吸变得吃力；考虑为心力衰竭诱发。给予常规心力衰竭药物治疗。
第 28 天，猪的状况恶化。第 29 天，在猪死亡前进行的超声心动图检查显示大量心包积液，主要位于右心的外侧和前壁，有几个纤维渗出带。右心严重受压，右心室极小。紧急开胸手术不成功。病理检查显示心包严重增厚、纤维化。心包囊扩张（高达 4.5 厘米），充满深褐色、柔软、易碎的物质。心包内可见心外膜出血伴新鲜、有组织的血栓。
在开胸手术后至少 15 天发生的延迟性填塞在大型动物模型中很容易被误诊或忽视，因为研究人员通常更关注主要的病理模型变化。为了降低动物模型的死亡率，研究人员应该意识到潜在的并发症，并对大型动物进行与临床护理相同水平的随访监测。
