• Title/Summary/Keyword: Pericardiotomy

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Clinical Experience of Pericardial Effusion (심낭삼출 환자의 임상적 고찰)

  • 최덕영
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.487-490
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    • 1995
  • We have experienced the 37 patients of pericardial effusion during last 8 years[1986-1993 . They were 17 male and 20 female patients, and their age range was 6months to 80 years.The causes of this pericardial effusion were 10 cases of tuberculosis, 7 cases of malignancy, 2 cases of acute pyogenic infection, 2 cases of postpericardiotomy pericardial effusion, 2 cases of trauma, 1 case of congenital heart disease, 1 case of SLE, and other 12 cases of unknown origin. All patients, except one, were managed by pericardiotomy with subxiphoid tube drainage. One case was managed by pericardiectomy. After operation, their symptoms and sign were dramaticaly improved. However, 3 patients were died postoperatively. Two of them were died of respiratory failure. One of them was died 28 months later with unrelated cause. They have already far advanced lung cancer. We conclude that the pericardiotomy with subxiphoid tube drainage was effective treatment in the patients with pericardial effusion.

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Percutaneous Transcatheter Pericardiotomy of Pericardial Effusion in a Miniature Poodle Dog (심한 심낭수 삼출이 있는 푸들개의 카테터를 통한 부분적 심낭절개술)

  • Han, Suk-Hee;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.729-734
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    • 2010
  • An 11-year old, intact female Poodle (weighing 2.3 kg) was referred with signs of consistent coughing, dyspnea, poor exercise tolerance, and anorexia. Diagnostic imaging and laboratory studies revealed idiopathic hemorrhagic pericardial effusion complicated with ISACHC Ib stage of chronic mitral valvular degeneration. Percutaneous transcatheter pericardiotomy (PTP) was performed at the right precordium using alligator forceps with fluoroscopic guidance. Immediately after PTP, electrocardiogram and echocardiogram showed dramatic improvement of cardiac performance. Patient was released with the prescription of furosemide (1 mg/kg, bid, PO), enalapril (0.5 mg/kg, bid, PO), cephradine (20 mg/kg, bid, PO) for mild mitral regurgitation and post-management of infection. Diagnostic studies performed at 2 weeks after PTP revealed no further accumulation of pericardial effusion and improvement of clinical signs. The dog is currently medicated with enalapril and monitored regularly.

Acute Heart Failure after Relief of Massive Pericardial Effusion (대량의 심낭삼출액 제거 후 발생한 급성 심부전)

  • Jung Tae-Eun;Lee Dong-Hyup
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.702-705
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    • 2006
  • Severe left ventricular dysfunction after relief of massive pericardial effusion has been rarely reported. Interventricular volume mismatch, acute distention of the cardiac chambers and interplay of autonomic none system are believed to be the possible causes for ventricular dysfunction. Presenting two patients who had marked decrease in global ventricular systolic function after relief of pericardial tamponade by subxyphoid pericardial window, we recommend gradual removal of pericardial fluid under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

Temporary Closure for Sternotomy in Patient with Massive Transfusion Might Be Lethal

  • Kim, Maru;Kim, Joongsuck;Kim, Sung Jeep;Cho, Hang Joo
    • Journal of Trauma and Injury
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    • v.30 no.1
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    • pp.12-15
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    • 2017
  • A 58-year-old male visited our emergency room for multiple traumas from explosion. On initial evaluation, hemopneumoperitoneum with liver laceration (grade 4) and colon perforation was identified. Hemopericardium with cardiac tamponade was also identified. Shrapnel was detected in the right ventricle. Damage control surgery was planned due to condition of hypotension. In operation room, control over bleeding was achieved after sternotomy, pericardiotomy, and laparotomy. Massive transfusion was done during operation. After gauze packing, operation was terminated with temporary closure (TC). Sanguineous fluid was drained profusely. Disseminated intravascular coagulopathy was confirmed through laboratory findings. No extravasation was discovered at hepatic angiogram. On re-operation, there was no active bleeding but oozing from sternotomy site was identified. Bone bleeding was impossible to control. Finally, reoperation was ended after gauze packing and TC all over again. The patient could survive for only a day after re-operation.

Acute Suppurative Pericarditis Caused by Liver Abscess -1 case report- (간농양에 속발한 급성화농성 심 낭염 -1례 보고-)

  • 홍장수;노윤우
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.785-788
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    • 1996
  • Pericardial abscess due to liver abscess is a very rare disease, the result of which is usually fatal when untreated. But a combination of antibiotics therapy and pericardial drainage has broug t good result. A 32-year-old man was admitted to the emergency room because of fever and chilling sensation. Chest X-ray showed cardiomegaly and a mass lesion In the left lobe of liver on ultrasonography. The echocardiography revealed impending cardiac tamponade. Pus drainage of the liver abscess through per- foration of right diaphram and pericardiotomy were performed. The pericardium was thickened and 600 ml of purulent fluid and necrotic debris were drained. Fibrin clots were firmly attached to the undelying myocradium. Histological examination of the pericardium showed acute inflammation with microabsscess and Escherichia soli was cultured from pericardial pus. He was discharged after 4 weeks on antibiotics, but Doppler echocardiograpy revealed a slightly thickened pericardium with a mild constrictive physiology.

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A Case of Tuberculous Pericardial Abscess Mimicking Thymic Carcinoma (악성 흉선종으로 오인된 결핵성 심낭농양 1예)

  • Park, Ji-Young;Park, Seung-Ah;An, Young-Hwan;Jang, Gil-Su;Kim, So-Yeon;An, Jeung-Sun;Hong, Eun-Young;Lim, Soo-Young;Kim, Kun-Il;Seo, Jin-Won;Park, Sung-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.347-351
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    • 2011
  • We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.