Chronic pericardial hematoma with suppression of the right ventricle: a rare complication of a coronary artery aneurysm

The Thoracic and Cardiovascular Surgeon Reports
Markus SchlömicherJustus Thomas Strauch

Abstract

We present a case of a 67-year-old patient referred to our department with a pericardial mass lesion measuring 11 × 4 × 7.5 cm as diagnosed in computed tomography scan. The patient showed a history of progredient dyspnea. Video-assisted thoracoscopy as well as an explorative full sternotomy to resect the mass lesion had been performed at the referring hospital subsequently before admission to our department. Intermittent hemodynamic instability caused the procedure to stop and a transfer to the cardiothoracic surgery department, following which a resternotomy was performed. Inspection of the surgical site and subsequent intraoperative rapid section revealed an old organized and dense pericardial hematoma adherent to the right ventricle. The suspicion of covered coronary artery perforation led to an intraoperative coronary angiography, which revealed a large proximal coronary aneurysm of the right coronary artery and a subtotal stenosis of the circumflex branch. The hematoma could be removed with decompression of the right ventricle under cardiopulmonary bypass conditions. The further postoperative course was uncomplicated with retransfer to the referring hospital on the postoperative day 8.

Methods Mentioned

BETA
coronary artery bypass

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Related Papers

General Thoracic and Cardiovascular Surgery
Satsuki KomodaRoland Hetzer
The Heart Surgery Forum
Adam H HamawyLeonard N Girardi
Kyobu geka. The Japanese journal of thoracic surgery
Yoshitaka TakedaH Nagano
Kyobu geka. The Japanese journal of thoracic surgery
S YamamotoN Hino
© 2021 Meta ULC. All rights reserved