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[Asymptomatic Chronic Expanding Hematoma Following Previous Cardiac Surgery Diagnosed by Computed Tomography-guided
Eiji Yoshikawa1, Ichiro Hayashi, Ichiro Kashima
1Department of Cardiovascular Surgery, Self Defence Forces Central Hospital, Tokyo, Japan.
Insights
A rare cardiac mass diagnosed as a chronic expanding hematoma after prior heart surgery was identified using computed tomography (CT) and confirmed via biopsy. This case highlights a unique complication following atrial septal defect repair.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- A 48-year-old male presented with an incidentally discovered intrapericardial mass.
- The patient had a history of surgical closure for an atrial septal defect 23 years prior.
Observation:
- Echocardiography and CT indicated right ventricular compression by the mass, yet the patient remained asymptomatic with no signs of right ventricular overload.
- Magnetic resonance imaging demonstrated a mosaic pattern with diverse signal intensities.
Findings:
- A CT-guided biopsy was performed, and histological examination confirmed the mass as a hematoma.
- This represents the first reported instance of a chronic expanding hematoma following cardiac surgery, diagnosed via CT-guided biopsy.
Implications:
- This case expands the differential diagnosis for intrapericardial masses, particularly in patients with a history of cardiac surgery.
- Highlights the utility of advanced imaging and targeted biopsy in diagnosing rare post-surgical complications.
- Suggests the possibility of delayed hematoma formation as a long-term sequela of cardiac procedures.
Abstract:
A 48-year-old man was referred to our hospital with an intrapericardial mass, which was incidentally found by computed tomography( CT) in a health check-up. He had undergone surgical closure of atrial septal defect 23 years ago. Although echocardiography and CT revealed compression of the right ventricle by a mass, he had no symptoms and echocardiography revealed no significant right ventricular overload. Magnetic resonance imaging revealed a mosaic pattern of various signal intensities. We performed a CT-guided biopsy, and the histological result was a hematoma. This was the first reported case of chronic expanding hematoma following previous cardiac surgery diagnosed by CT-guided biopsy.
