Smart K, Jett G K
Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, Texas, USA.
Ann Thorac Surg. 1998 Dec;66(6):2027-8. doi: 10.1016/s0003-4975(98)01044-3.
Circulatory support with mechanical devices often leads to bleeding and tamponade.
We report a series of three patients that required mechanical circulatory support for postcardiotomy ventricular dysfunction.
Late tamponade occurred in each patient with different clinical presentations. Early postoperative bleeding occurred in 2 patients. There was no active bleeding in any of the 3 patients. Transesophageal echocardiography was not helpful in making the diagnosis.
Late tamponade, which may be the result of hematoma with earlier bleeding, can present as dyspnea, hypoxia, or forms of hemodynamic collapse. Exploratory media sternotomy is required to definitively make the diagnosis and to evacuate the hematoma.
使用机械装置进行循环支持常导致出血和心包填塞。
我们报告了一系列3例因心脏手术后心室功能障碍而需要机械循环支持的患者。
每位患者均发生了迟发性心包填塞，临床表现各异。2例患者术后早期出血。3例患者均无活动性出血。经食管超声心动图对诊断无帮助。
迟发性心包填塞可能是早期出血形成血肿的结果，可表现为呼吸困难、低氧血症或血流动力学崩溃的形式。需要进行正中胸骨切开探查以明确诊断并清除血肿。
