Key result
Relieving localized intraoperative cardiac tamponade enables successful cardiopulmonary bypass weaning without inotropic support.
Case Report (n=1)
Highlights the risk of localized intraoperative cardiac tamponade from vent site bleeding dissecting between the heart and adherent pericardium during reoperative cardiac surgery.
A 65-year-old lady had undergone mitral and aortic valve replacement following an open mitral valvotomy and aortic valve exploration 5 years earlier. At reoperation, following sternotomy, extensive adhesions were encountered and it was decided to perform minimal dissection of the heart. Both the aortic and mitral valves were replaced using 23 mm and 29 mm St. Jude bileaflet valves, respectively. At the end of the procedure it was difficult to wean the patient off bypass as her mean arterial pressure dropped and the heart became dilated. It was found that a tamponade had developed, as a result of bleeding from the vent site in the pulmonary artery, and dissected a plane between the heart and the adherent pericardium. Her condition improved dramatically as the tamponade was released and she came off cardiopulmonary bypass with no inotropic support.
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Asham et al. (1996) conducted a case report in Localized intraoperative cardiac tamponade (n=1). Release of tamponade was evaluated on Clinical improvement and weaning off cardiopulmonary bypass. Release of a localized intraoperative cardiac tamponade allowed a 65-year-old woman undergoing valve replacement reoperation to be successfully weaned off cardiopulmonary bypass without inotropic support.
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