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Late cardiac tamponade after open-heart surgery
1Thoracic Surgical Clinic, Karolinska Hospital, Stockholm, Sweden.
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1991
Summary
Late cardiac tamponade, a complication after open-heart surgery, occurred in 1.3% of patients. Echocardiography aided diagnosis, and while pericardiocentesis was often successful, surgical intervention was sometimes necessary.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Late cardiac tamponade is a recognized complication following open-heart surgery.
- The incidence and management strategies for this condition require ongoing investigation.
Purpose of the Study:
- To determine the incidence of late cardiac tamponade after open-heart surgery.
- To evaluate the effectiveness of diagnostic and treatment modalities, including pericardiocentesis and surgery.
- To assess long-term outcomes and survival rates in patients who develop late cardiac tamponade.
Main Methods:
- Retrospective analysis of patients who underwent open-heart surgery.
- Diagnosis confirmed primarily by echocardiography.
- Treatment strategies included pericardiocentesis and surgical intervention.
- Long-term follow-up to assess recurrence and survival.
Main Results:
- Overall incidence of late cardiac tamponade was 1.3%, higher after valve operations (2.6%) than coronary surgery (0.7%).
- Echocardiography diagnosed 93% of cases; pericardiocentesis was successful in 80% of attempted cases.
- Failure of pericardiocentesis was linked to fluid location, clots, small effusion size, or myocardial insufficiency.
- Five percent of patients died within 30 days; the 5-year survival rate was 73%.
Conclusions:
- Late cardiac tamponade is an infrequent but significant complication of open-heart surgery.
- Pericardiocentesis is an effective initial treatment, but surgical intervention may be required in select cases.
- Long-term survival is considerable, though recurrence of effusion can occur.
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