Meurin P, Lardoux H, Thoin F, Salloum J, Mousseaux E, Isnard R, Thomas D
Service de Cardiologie, Hôpital de la Pitié-Salpêtrière, Paris.
Ann Cardiol Angeiol (Paris). 1996 Nov;45(9):503-6.
Right intrapericardial retroatrial haematomas are usually discovered in an acute context of tamponade, following cardiac surgery. The original feature of this case was the asymptomatic nature of a right retroatrial haematoma, after surgical closure of an ostium secundum atrial septal defect, with a free interval of more than 20 years between the surgical procedure and the first relatively minor symptoms, consisting of supraventricular arrhythmias. It can be difficult to determine the intra- or extra-atrial topography of a right-sided mass by transthoracic echocardiography. On the other hand, transoesophageal echocardiography and ultrafast CT can provide a precise topographic diagnosis and appear to be complementary to assess the nature of pericardial masses.
右心室内心包后房血肿通常在心脏手术后的急性心包填塞情况下被发现。该病例的独特之处在于,在继发孔型房间隔缺损手术闭合后出现右房后血肿,且无症状,手术与首次出现包括室上性心律失常在内的相对轻微症状之间有超过20年的间隔期。经胸超声心动图难以确定右侧肿块位于心房内还是心房外。另一方面,经食管超声心动图和超快CT能够提供精确的定位诊断,并且在评估心包肿块性质方面似乎具有互补性。