An Operated Case of Cardiac Compression by Chronic Expanding Hematoma in the Pericardial Cavity after Cardiac Surgery

iDepartment of Cardiovascular Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan and Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine*, Kyoto, Japanj

Masahiro Dohi* Tomoya Inoue Taiji Watanabe*
Osamu Sakai Akiyuki Takahashi Yuichirou Murayama*
Masamichi Nakajima
A rare surgical case of chronic expanding hematoma in the pericardial cavity is reported. A 78-year-old man had undergone coronary artery bypass grafting 2 years previously. He had suffered from general malaise, increasing shortness of breath and systemic edema from 18 months after the operation. Echocardiography revealed an intrapericardial mass compressing the cardiac chambers resulting in insufficiency of the ventricular expansion. Under extracardiopulmonary bypass and cardiac beating, resection of the mass and additional coronary artery surgery were implemented. The mass was encapsulated with thick fibrous membrane containing old degenerated coagula the bacterial culture of which was negative and was histopathologically diagnosed as chronic expanding hematoma. The patientfs postoperative course was uneventful and symptoms with cardiac failure were relieved. There has been no recurrence for more than 18 months.
  Jpn. J. Cardiovasc. Surg. 38:130-134i2009j