Pericardial clot compressing the right chambers in 15 patients produced low cardiac output with small left ventricular end-diastolic diameter (38.4 +/- 10.1 mm) and prominent 'y' trough.
Observational (n=15)
Pericardial clot after open-heart surgery presents with atypical hemodynamics resembling constrictive pericarditis rather than typical fluid tamponade, and can be effectively treated with emergency clot removal.
Transoesophageal echocardiography disclosed a localized pericardial blood clot compressing the right atrium (RA) and/or right ventricle (RV) in 15 patients suffering from low cardiac output failure soon after open-heart surgery. The left ventricular end-diastolic diameter was small (38.4 +/- 10.1 mm) and its fractional shortening normal (34.9 +/- 10.2%). These findings suggested cardiac tamponade as a result of pericardial clot. However, the 'y' trough of the RA pressure tracing was prominent, which is not characteristic of typical cardiac tamponade, but rather of constrictive pericarditis. This implies therefore that the pathophysiology of cardiac tamponade by pericardial clot differs from that of tamponade by fluid. Emergency open-chest removal of the pericardial clot was performed in seven patients, with good results. Pericardial clot produces low cardiac output soon after open-heart surgery, but its location is specific and its haemodynamics are not characteristic of cardiac tamponade.
Beppu et al. (Tue,) conducted a observational in Low cardiac output failure after open-heart surgery (n=15). Pericardial clot was evaluated. Pericardial clot compressing the right chambers in 15 patients produced low cardiac output with small left ventricular end-diastolic diameter (38.4 +/- 10.1 mm) and prominent 'y' trough.
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