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Localized pericardial tamponade: Does it always need exploration?


1 Department of Cardiac Anesthesia, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
2 Department of Cardiac Surgery, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India

Correspondence Address:
Monish S Raut
Department of Cardiac Anesthesia, Dharma Vira Heart Center, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi - 110 060
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.124149

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Year : 2014  |  Volume : 17  |  Issue : 1  |  Page : 67-69

 

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A 48-year-old female patient underwent coronary artery bypass surgery. One-hour after surgery, the patient developed hemodynamic instability. Transthoracic echocardiography (TTE) was inconclusive. Transesophageal echocardiography (TEE) was performed and it revealed localised collection around right atrium. In spite of the evidence of localized tamponade, wait and watch policy was employed rather than re-exploring the patient emergently. The patient recovered uneventfully. If hemodynamics remain stable and there is no fall in hematocrit and no increase in effusion on TEE/TTE examination, then localized tamponade can be managed conservatively without reexploring the patient.






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1 Department of Cardiac Anesthesia, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
2 Department of Cardiac Surgery, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India

Correspondence Address:
Monish S Raut
Department of Cardiac Anesthesia, Dharma Vira Heart Center, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi - 110 060
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.124149

Rights and Permissions

A 48-year-old female patient underwent coronary artery bypass surgery. One-hour after surgery, the patient developed hemodynamic instability. Transthoracic echocardiography (TTE) was inconclusive. Transesophageal echocardiography (TEE) was performed and it revealed localised collection around right atrium. In spite of the evidence of localized tamponade, wait and watch policy was employed rather than re-exploring the patient emergently. The patient recovered uneventfully. If hemodynamics remain stable and there is no fall in hematocrit and no increase in effusion on TEE/TTE examination, then localized tamponade can be managed conservatively without reexploring the patient.






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