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Posterior pericardial effusion affecting hemodynamics occurred late after cardiac surgery. left mini-thoracotomy as an alternative surgical approach to redo sternotomy. three case reports
Full text linkAlthough sternotomy represents the main surgical access for most cardiac interventions, there are some cases in which alternative surgical approaches may be safer. A re-sternotomy may determine, in patients affected by posterior or very lateral pericardial effusion or mass and in redo-surgery procedures, an increased risk of injury to cardiac structures or previously placed bypass grafts. Moreover concern can arise
about sternal wound dehis-cences, late recovery from ICU, nosocomial pneumonia and prolonged hospital stay. A different surgical ap-proach should be taken into account, whenever feasible, in order to reduce those risks and improve the outcomes. Below are reported three successful surgical treatments of hemodynamically compromising pericardial effusion occurred as a late complication of cardiac surgery through a lateral pericardial window via a left mini-thoracotomy. This approach was found to be as reliable as effective and definitive. The expected post procedural pain was well controlled with common pain killers and all the three patients could benefit from a short hospital stay
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