Management of Cardiac Tamponade After Cardiac Surgery

Feasibility of diagnosis of postcardiotomy tamponade by miniaturized transesophageal echocardiography

“…5 The incidence of the pericardial tamponade varies from 0.2% after coronary artery bypass grafting to 8.4% after heart transplants. 6 The concern of developing post-surgical pericardial tamponade has been increasing in patients especially those on a new generation of antiplatelet agents and/or anticoagulants.…”

An evaluation of diagnostic sensitivity of transthoracic echocardiography in diagnosis of post-cardiac surgery tamponade

“…[1,3,8,9,[12][13][14][15] Furthermore, the mortality rate after reoperation ranged from 3.5-37.5%, depending on the patient characteristics along with the inclusion and exclusion criteria. In our study, mortality occurred in 28 patients (38.3%) with LCOS, with respiratory pathologies being the most frequent causes.…”

“…This so called low pressure cardiac tamponade may develop with diastolic pressures as low as 3-6 mmHg. [1,22] Although pulsus paradoxus is also an important key for diagnosing cardiac tamponade in non-surgical patients, it loses its significance in the postoperative setting. Positive pressure ventilation is another factor which prevents pulsus paradoxus from occurring as a manifestation of ventricular interdependence.…”

“…Moreover, when there is a tendency toward postoperative bleeding, the typical signs and symptoms may not be present unless the hemodynamic status becomes severely compromised. [1] Furthermore, the absence of fluid accumulation during echocardiographic evaluations may be deceiving, especially when the clinical picture is atypical, and this may cause further delays in the diagnosis. [4] A number of previous studies have focused on trying to determine to what extent echocardiographic evaluations provide reliable information in the diagnosis of postoperative cardiac tamponade.…”

“…[1] A clinical manifestation like this may be the consequence of a variety of overlapping conditions, including anemia, fluid or hematoma compression, and poor ventricular function, but cardiac tamponade comes to mind first, especially when the hemodynamic impairment does not respond to general measures that are undertaken to normalize the patient's blood pressure and cardiac performance.…”