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Eur J Cardiothorac Surg 2008;33:738. doi:10.1016/j.ejcts.2008.01.009
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

Pseudo cardiac tamponade: a rare complication of temporary epicardial pacing wires

Enoch F. Akowuah, Rajani Rajnish, Sally Tomkins, Jonathan Hutter*

Department of Cardiothoracic Surgery, The Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HN, United Kingdom

Received 29 October 2007; received in revised form 5 January 2008; accepted 6 January 2008.

* Corresponding author. Tel.: +44 117 342 0501; fax: +44 117 342 0472. (Email: jonathan.hutter{at}ubht.swest.nhs.uk).

Key Words: Echocardiogram • Haematoma • Aortic valve

An 87-year-old woman developed cardiac tamponade, 24 h after aortic valve replacement (AVR), confirmed by trans thoracic echo (TTE). Intraoperatively, no blood was observed within the pericardium. A bruised area over the right ventricular outflow track was noted. An intraoperative trans oesophageal echo (TOE) revealed a subepicardial haematoma compressing the right ventricle, secondary to subepicardial bleeding from the epicardial pacing wires (Fig. 1 ).


Figure 1
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  		Fig. 1. Intraoperative transoesophageal echocardiogram of the subepicardial haematoma causing right ventricular compression.

 





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Enoch F. Akowuah
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