Diagnosis and management of postoperative pericardial effusions and late cardiac tamponade following open-heart surgery

A. M. Borkon, Hartzell V Schaff, T. J. Gardner, W. H. Merrill, R. K. Brawley, J. S. Donahoo, L. Watkins, J. L. Weiss, V. L. Gott

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41 Scopus citations

Abstract

The clinical and laboratory findings of 28 patients identified as having late pericardial effusions were examined. Eleven of these patients were asymptomatic; 9 patients had moderate symptoms including fatigue, malaise, weight gain, and dyspnea on exertion, and 8 patients with similar symptoms had evidence of cardiac tamponade. Ten patients underwent right heart catheterization in the intensive care unit; normal hemodynamics were confirmed in 4 and cardiac tamponade in 6 patients. Pericardiocentesis was effective in decompressing cardiac tamponade in 7 of 8 patients. One patient required operative subxiphoid drainage after unsuccessful pericardiocentesis. In addition, 5 patients with moderate clinical symptoms and pericardial effusions, who did not have cardiac tamponade, underwent pericardiocentesis because of a need for chronic anticoagulant therapy. The remaining patients were managed succesfully by observation, discontinuation of warfarin when possible, fluid restriction, and diuretic therapy. All but 1 patient was symptomatically improved. A diagnostic and therapeutic schema is presented as an aid to early recognition of this troublesome and potentially lethal complication.

Original languageEnglish (US)
Pages (from-to)512-519
Number of pages8
JournalAnnals of Thoracic Surgery
Volume31
Issue number6
DOIs
StatePublished - 1981
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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    Borkon, A. M., Schaff, H. V., Gardner, T. J., Merrill, W. H., Brawley, R. K., Donahoo, J. S., Watkins, L., Weiss, J. L., & Gott, V. L. (1981). Diagnosis and management of postoperative pericardial effusions and late cardiac tamponade following open-heart surgery. Annals of Thoracic Surgery, 31(6), 512-519. https://doi.org/10.1016/S0003-4975(10)61340-9