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Chronic expanding hematoma in the pericardial cavity after cardiac surgery
Shinji Hirai1, Yoshiharu Hamanaka, Norimasa Mitsui
1Department of Thoracic and Cardiovascular Surgery, Hiroshima Prefecture Hospital, Hiroshima, Japan.
Insights
A rare chronic expanding hematoma in the pericardial cavity was successfully surgically treated. This large cardiac mass, developing over years, required left thoracotomy for complete resection.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pathology
Background:
- Presents a rare case of chronic expanding hematoma (CEH) in the pericardial cavity.
- Highlights the importance of considering CEH in patients with a history of cardiac surgery.
- Discusses the diagnostic challenges and management of large pericardial masses.
Observation:
- A patient with prior cardiac surgeries (double-outlet right ventricle, tricuspid regurgitation) developed a slowly growing mass near the left atrium and ventricle.
- The mass, identified as a chronic expanding hematoma, progressively enlarged over five years.
- Imaging and clinical presentation were crucial in diagnosing the pericardial hematoma.
Findings:
- Successful surgical resection of a large chronic expanding hematoma from the pericardial cavity via left thoracotomy.
- Histopathological confirmation of the resected mass as a chronic expanding hematoma.
- Complete removal of the mass achieved without immediate complications.
Implications:
- Demonstrates the feasibility and success of surgical intervention for large pericardial chronic expanding hematomas.
- Emphasizes the need for vigilance in diagnosing and managing rare cardiac masses, especially in post-cardiac surgery patients.
- Contributes to the understanding of the natural history and treatment of pericardial CEH.
Abstract:
We report the successful surgical treatment of a rare case of chronic expanding hematoma in the pericardial cavity that developed into a very large mass over a long period. The patient, who had a history of cardiac surgery for a double-outlet right ventricle 14 years previously and for tricuspid regurgitation 8 years ago, noticed a slowly growing mass near the left atrium and ventricle 5 years ago. The mass, which confirmed a diagnosis of chronic expanding hematoma, was resected by left thoracotomy.