Low cardiac output complicating pericardiectomy for pericardial tamponade.
Low cardiac output complicating pericardiectomy for pericardial tamponade.
复制标题
低心输出量使心包填塞心包切除术复杂化。
DOI：
10.1016/s0003-4975(98)01143-6
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发表时间：
1999
影响因子：
4.6
通讯作者：
V. Bosek
中科院分区：
文献类型：
--
作者：
Renee Sunday;L. Robinson;V. Bosek
肿瘤累及心包导致积液和随后的心包填塞是一种需要立即减压的急症，通常通过剑突下心包切除术安全完成。然而，本病例报告描述了一例心包填塞患者，该患者接受了手术减压，血流动力学短暂改善，随后迅速发展为进行性心力衰竭和死亡。这种心包减压的反常反应，类似于在缩窄性心包炎的心包切除术中偶尔看到的反应，可能比目前认识的更常见。其原因可能与从积液中突然去除慢性心室外支持导致心室扩张和衰竭有关。
Neoplastic involvement of the pericardium resulting in an effusion and subsequent tamponade is an emergency requiring prompt decompression, generally safely accomplished by subxiphoid pericardiectomy. However, the current case report describes a patient with florid pericardial tamponade who underwent surgical decompression with transient hemodynamic improvement, who then rapidly developed progressive, heart failure and death. This paradoxical response to pericardial decompression, similar to that seen occasionally with pericardiectomy in constrictive pericarditis, may be more frequent than currently appreciated. Its cause may relate to the sudden removal of the chronic external ventricular support from the effusion resulting in ventricular dilatation and failure.