Cardiac failure caused by intrapericardial chronic expanding hematoma 18 years after CABG

Chronic expanding hematoma(CEH)was first recognized by Reid in 1980. It begins to expand chronically more than 1 month after surgery or trauma, which is considered the possible cause of bleeding. It resembles chronic subdural hematoma. Most of the reports on CEH are those in the thoracic cavity or m...

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Bibliographic Details
Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 65; no. 10; p. 885
Main Authors Ono, Hirokuni, Abe, Hiroyuki, Sakurai, Yuka, Endou, Hitoshi, Chiba, Kiyoshi, Oono, Makoto, Kitanaka, Yousuke, Makuuchi, Haruo
Format Journal Article
LanguageJapanese
Published Japan 01.09.2012
Subjects
Chronic Disease
Coronary Artery Bypass
Heart Failure - etiology
Hematoma - etiology
Hematoma - pathology
Hematoma - surgery
Humans
Male
Middle Aged
Pericardium
Postoperative Complications
Time Factors
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Summary:Chronic expanding hematoma(CEH)was first recognized by Reid in 1980. It begins to expand chronically more than 1 month after surgery or trauma, which is considered the possible cause of bleeding. It resembles chronic subdural hematoma. Most of the reports on CEH are those in the thoracic cavity or muscles, and few are in the pericardial cavity after open heart surgery. Our case was a 64-year-old male, who had undergone coronary artery bypass grafting (CABG) 18 years before. He presented with symptoms of heart failure such as exertional dyspnea, general fatigue and appetite loss. Computed tomography( CT) scan showed severe compression of the left ventricle by a large mass, and he was diagnosed with intrapericardial CEH. Resection of the severely calcified epicardium as well as removal of the hematoma in the pericardial cavity was performed, and the symptoms of heart failure improved. No recurrence has been noted for 1 year since the operation. A long-term follow-up will be necessary.
ISSN:0021-5252