EXPERIENCE WITH CARDIAC-TAMPONADE FOLLOWING OPEN-HEART-SURGERY

Cardiac tamponade following open heart surgery is well described, alth ough, fortunately, uncommon. Unlike more classical ''primary'' tampona de, the clinical features are not specific, and this can delay diagnos is. In practice, the threshold for investigation must be low, and echo cardiography has been invaluable in the detection and localization of pericardial collections. Several factors are believed to contribute to the likelihood of postoperative tamponade, but the mechanisms are not clearly understood. Resternotomy, under general anesthesia, or subxip hoid pericardiotomy, under local or general anesthesia, are effective forms of treatment. However, recent success with the use of percutaneo us pericardiocentesis under echocardiographic guidance has shown that postoperative tamponade can be treated safely and effectively by this method.