Isoda N, Nakamura C, Watanabe T, Aoyama K, Inazawa K, Iijima Y, Washio M, Hoshi H, Masakane N
Second Department of Surgery, Yamagata University School of Medicine, Japan.
Kyobu Geka. 1994 Aug;47(9):758-61.
We report a case of localized cardiac tamponade after aortic valve replacement. A 56-year-old man had an aortic valve replacement for his aortic valve steno-insufficiency. At 3-postoperative day, severe hypotension occurred, causing acute renal failure. There were no cardiomegaly, high central venous pressure, nor echo-free space. A mass shadow, appearing on chest X-ray at 37-postoperative day, was diagnosed as a localized tamponade by means of a computed tomography and a radioangiography at 38 postoperative day. After the spontaneous drainage of old bloody effusion from the partially opened wound in mid-line, his cardiac and renal failure improved rapidly. When the hematoma is localized, computed tomography is most diagnostic while conventional echo-cardiography often fails to show echo-free spaces.
我们报告一例主动脉瓣置换术后发生局部心脏压塞的病例。一名56岁男性因主动脉瓣狭窄伴关闭不全接受了主动脉瓣置换术。术后第3天,出现严重低血压,导致急性肾衰竭。当时没有心脏扩大、中心静脉压升高,也没有无回声区。术后第37天胸部X线出现肿块阴影,术后第38天通过计算机断层扫描和放射性血管造影诊断为局部压塞。自中线部分开放伤口自行排出陈旧性血性积液后,他的心脏和肾衰竭迅速改善。当血肿局限时,计算机断层扫描最具诊断价值,而传统超声心动图往往无法显示无回声区。