Cardiac Tamponade

[charles g]

I'd never heard of this until approx 2 days after AVR which went very well but then it happened. A ICU PA decided that I was ready to have the draining tube removed which she did..a few hours later I was rushed back to surgery and reopened to relief the huge pressure on my barely beating heart..I almost didn't make it needless and sadly to say. I was eventually released and tomorrow I will see my heart surgeon and I'm wondering exactly why this happened although I have my suspicions.. but I don't think the surgeon made that call, I do think it was the PA's call in ICU, I'm just not sure? I read Cardiac tamponade only occurs 1 in 25000 procedures..it was staggering to believe.

Hopefully no collateral damage but it's too soon to tell. I'll post more followup as I get them and as always look forward to hearing your comments.

 

[pellicle]

Wow

Never heard of it either

http://en.m.wikipedia.org/wiki/Cardiac_tamponade

 

[skeptic49]

Yes! I had it too! I had my surgery on Monday, February 16. Tuesday I felt pretty well but then I went into a decline. I kept telling the doctors that I was not feeling well...totally weak, no strength at all. Friday morning they tried to get me out of bed and I passed out. A heart cath was done and the decision was made to send me back into the OR. Fluid and clots were removed from around my heart...cardiac tamponade. After my second surgery my recovery finally got on track.

 

[Midpack]

Hi! Glad to know you are both finally doing well.

I am of course missing something obvious, but i will ask it anyway, just to understand. If the pericardium is cut when performing valve surgery, and, as far as i know, it is usually not sewn afterwards, how can fluid accumulate into an opened sac?

 

[dwhist]

During week 8 and 9 after my AVR I had noticed I was getting out of breath and went to doc end of week 9. He could find nothing wrong and sent me on my way. I did a 10 mile bike ride that weekend and was out of breath. On Tuesday the next week doc called and asked me to swing by hospital for a CT scan, he wanted to see if any blood clots in lungs. Had scan and they told me not to eat or drink anything and wait for call from doc. Then they came and got me and did an echo and again told me to not eat or drink anything and wait for doc to call. They then came and got me and said they were admitting me and took me down to admitting. They tried putting iv in but could not hit a vein and then nurse from Docs office came in. His office is in building connected to Hospital. She said the doc was going to do a procedure as there was some fluid around the heart. She said it was a simple 15 minute operation. It was at this point for some reason I looked at my hand and noticed my finger nails were blue. They took me to same OR they did heart valve in and knocked me out. When I woke up they had cut about 2 inches down from the last incision and there was a drain tube. My wife said they wanted to move fast as they where afraid heart was going to stop and it is hard for them to restart it when it is surrounding by fluid. They took out a liter of what I was told was mostly old blood.

Kept me for 3 nights and let me go. They put me on Prednisone for a few days saying there may have been inflammation causing issue of fluid. No affects of any kind after that and it has been over 3 years. I know there was another member here who had it happen many weeks out. You may be able to search boards.

My understanding is some docs including mine sew up the pericardial sac. Otherwise the heart has a tendency to attach to the back of breast bone making next surgery harder. For the second surgery he did a pericardial window where he made a small cut and drained the fluid out. I was told it would seal itself up over time.

Search the boards and I am sure you will find more information.

 

[ottagal]

That is quite the ordeal you and Skeptic have been through. Onwards and upwards with your recovery. Will be interested to hear what the surgeon has to say. I had pleural and pericardial effusions along with Dressler's and I know how crappy I felt post-op. Fortunately, I didn't have to be re-opened.
Wishing you all the very best.