Komplikationen durch die Kontrastmittelgabe

Schönenberger, Eva; Mühler, Matthias; Dewey, Marc

doi:10.1007/s00108-010-2760-9

Cited by 9 publications

(1 citation statement)

References 39 publications

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“…Otherwise, contrast medium supported CT imaging features the risk of renal impairment and allergy-like reactions [16]. Despite this risk for imaging-related complications, a non-acute pericardial tamponade is displayed effectively via suplemental CT imaging with high sensitivity and specificity, as frequently reported after blunt chest trauma [17-19].…”

Section: Discussionmentioning

confidence: 99%

Delayed cardiac tamponade after open heart surgery - is supplemental CT imaging reasonable?

Floerchinger

Camboni

Schopka

et al. 2013

J Cardiothorac Surg

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BackgroundCardiac tamponade is a severe complication after open heart surgery. Diagnostic imaging is challenging in postoperative patients, especially if tamponade develops with subacute symptoms. Hypothesizing that delayed tamponade after open heart surgery is not sufficiently detected by transthoracic echocardiography, in this study CT scans were used as standard reference and were compared with transthoracic echocardiography imaging in patients with suspected cardiac tamponade.MethodTwenty-five patients after open heart surgery were enrolled in this analysis. In case of suspected cardiac tamponade patients underwent both echocardiography and CT imaging. Using CT as standard of reference sensitivity, specificity, positive and negative predictive values of ultrasound imaging in detecting pericardial effusion/hematoma were analyzed. Clinical appearance of tamponade, need for re-intervention as well as patient outcome were monitored.ResultsIn 12 cases (44%) tamponade necessitated surgical re-intervention. Most common symptoms were deterioration of hemodynamic status and dyspnea. Sensitivity, specificity, positive and negative predictive values of echocardiography were 75%, 64%, 75%, and 64% for detecting pericardial effusion, and 33%, 83%, 50, and 71% for pericardial hematoma, respectively. In-hospital mortality of the re-intervention group was 50%.ConclusionDiagnostic accuracy of transthoracic echocardiography is limited in patients after open heart surgery. Suplemental CT imaging provides rapid diagnostic reliability in patients with delayed cardiac tamponade.

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Section: Discussionmentioning

confidence: 99%