[Cardiac Failure Developing Eleven Years after Coronary Artery Bypass Grafting;Report of a Case]

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Intrapericardial hematoma is a rare but serious complication.
• Delayed presentation of cardiac complications after coronary artery bypass grafting (CABG) can occur.
• Cardiac tamponade requires prompt diagnosis and intervention.

Observation:

• A 59-year-old male presented with cardiac tamponade 11 years after CABG.
• Imaging revealed a large intrapericardial mass compressing the left ventricle.
• Coronary angiography showed a total occlusion in the circumflex branch.

Findings:

• The mass was diagnosed as an intrapericardial hematoma, weighing 126g.
• The patient had a history of diabetes mellitus.
• A potential cause was slow oozing from left ventricular free wall rupture following an asymptomatic myocardial infarction.

Implications:

• This case underscores the importance of considering rare, delayed complications following CABG.
• Long-term surveillance for cardiac issues in post-CABG patients, especially those with comorbidities like diabetes, is crucial.
• Prompt surgical evacuation of intrapericardial hematoma is essential for managing cardiac tamponade.