Objective:
Our aim is to discuss etiological factors, approaches of surgical drainage, and effective therapeutic methods for patients of late cardiac tamponade after cardiac surgery for whom medical treatment is insufficient.
Introduction:
Cardiac tamponade is the most important complication of pericardial effusion that occurs after open heart surgery. In cardiac tamponade the diastolic filling of the heart is hindered and this gives rise to cardiac compression. Emergent surgical drainage should be performed to relieve cardiac compression. In this retrospective study methods of surgical drainage performed in our hospital were evaluated in the light of literature.
Material and Methods:
23 cases of late cardiac tamponade were identified among 1150 cases of open heart surgery between January 2008 and December 2015 in Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital. Demographic information, primary surgical procedures, and factors resulting in late tamponade of the operated patients were determined.
Results:
Tamponade was clinically evident at postoperative days 18-70 (41.3+5) after primary surgery. INR >3.5, early postoperative drainage, postpericardiectomy syndrome and idiopathic trombocytopenia (≤50.000) were found to be possible etiological factors. Patients were discharged on a mean of 7 days postoperatively and followed up for 3 years. On follow ups 4 (%16) patients showed reoccurence. The hospital’s mortality rate was found to be 2/23 (8%).
Conclusion:
Early diagnosis and correct treatment approach are paramount in late cardiac tamponade after open heart surgery. Surgical drainage should be applied where medical treatment is insufficient. Correct treatment approach and surgical drainage technique determine the efficacy of treatment.
Keywords: cardiac surgery, late cardiac tamponade, surgical drainage