Surgical drainage of late cardiac tamponade following open heart surgery
THORACIC AND CARDIOVASCULAR SURGEON, cilt.53, sa.5, ss.285-290, 2005 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 53 Sayı: 5
- Basım Tarihi: 2005
- Doi Numarası: 10.1055/s-2005-837679
- Dergi Adı: THORACIC AND CARDIOVASCULAR SURGEON
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.285-290
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Background: There are few reports on postoperative late cardiac tamponade with surgical therapy in the literature. Methods: Hospital records of 87 patients with postoperative late cardiac tamponade who had undergone cardiac surgery between January 1999 and December 2003 were evaluated retrospectively. Results: Out of 8400 patients who had undergone cardiac surgery, 87 patients (1%) had postoperative late cardiac tamponade. The incidence was 0.1 % for patients with coronary artery bypass grafting and 3.4% for those with heart valve replacement (p < 0.01). Subxiphoid midline incision was carried out in 67 patients (77%). Conversion to re-sternotomy was required in 8 patients due to either ineffective drainage (5 patients, 7.5%) or laceration and bleeding (3 patients, 4.5%). Re-sternotomy was undertaken in 20 patients with no complication. Early death occurred in 3 patients with subxiphoid drainage (3.5%), two of which were related to bleeding. Out of 84 patients who survived, 10 patients had recurrent cardiac tamponade, 5 of which required surgical drainage (15%). Conclusions: Bleeding due to dense adhesions between the epicardium and the sternum may be encountered during subxiphoid drainage for postoperative late cardiac tamponade and lead to a 3% mortality rate.