109: CARDIAC TAMPONADE: A DELAYED COMPLICATION OF COVID-19

Chylopericardium after intrapericardial cardiac operations is extremely rare. We present an unusual case of postoperative chylopericardium with cardiac tamponade following atrial septal defect repair, and we comment on the clinical course and treatment.

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Cardiac Tamponade due to a Ruptured Solitary Mediastinal Varix: A Case Report

The Heart Surgery Forum ◽

10.1532/hsf98.20061185 ◽

2007 ◽

Vol 10 (3) ◽

pp. E199-E201

Author(s):

Toshio Kaneda ◽

Masahiko Onoe ◽

Soji Moriwaki ◽

Shin Kadota ◽

Osamu Baba ◽

...

Keyword(s):

Case Report ◽

Cardiac Tamponade

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Cardiac Tamponade due to Coronary Artery Erosion

The Heart Surgery Forum ◽

10.1532/hsf98.20051117 ◽

2005 ◽

Vol 8 (4) ◽

pp. E173-E174

Author(s):

Silvana Marasco ◽

Mark Fitzgerald ◽

Marco Larobina ◽

Donald Esmore

Keyword(s):

Coronary Artery ◽

Cardiac Tamponade

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An Unusual Case of Primary Cardiac Large B-cell Lymphoma Presenting as Cardiac Tamponade A in Chronically Immunosuppressed Patient

Cardiology and Cardiovascular Medicine ◽

10.26502/fccm.92920127 ◽

2020 ◽

Vol 04 (04) ◽

Author(s):

Daneshvar M ◽

Khalid Y ◽

Kaur L ◽

Dasu N ◽

Willard P ◽

...

Keyword(s):

B Cell ◽

Cardiac Tamponade ◽

Unusual Case ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Immunosuppressed Patient ◽

Large B Cell Lymphoma ◽

Large B Cell

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Evaluation and treatment of children with radiation-induced cerebral vasculopathy

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.7.peds19188 ◽

2019 ◽

Vol 24 (6) ◽

pp. 680-688

Author(s):

David S. Hersh ◽

Kenneth Moore ◽

Vincent Nguyen ◽

Lucas Elijovich ◽

Asim F. Choudhri ◽

...

Keyword(s):

Radiation Therapy ◽

Proton Beam ◽

Tumor Imaging ◽

Clinic Visit ◽

Surgical Patient ◽

Beam Radiation ◽

Proton Beam Radiotherapy ◽

Cranial Radiation ◽

Delayed Complication ◽

Radiation Induced

OBJECTIVEStenoocclusive cerebral vasculopathy is an infrequent delayed complication of ionizing radiation. It has been well described with photon-based radiation therapy but less so following proton-beam radiotherapy. The authors report their recent institutional experience in evaluating and treating children with radiation-induced cerebral vasculopathy.METHODSEligible patients were age 21 years or younger who had a history of cranial radiation and subsequently developed vascular narrowing detected by MR arteriography that was significant enough to warrant cerebral angiography, with or without ischemic symptoms. The study period was January 2011 to March 2019.RESULTSThirty-one patients met the study inclusion criteria. Their median age was 12 years, and 18 (58%) were male. Proton-beam radiation therapy was used in 20 patients (64.5%) and photon-based radiation therapy was used in 11 patients (35.5%). Patients were most commonly referred for workup as a result of incidental findings on surveillance tumor imaging (n = 23; 74.2%). Proton-beam patients had a shorter median time from radiotherapy to catheter angiography (24.1 months [IQR 16.8–35.4 months]) than patients who underwent photon-based radiation therapy (48.2 months [IQR 26.6–61.1 months]; p = 0.04). Eighteen hemispheres were revascularized in 15 patients. One surgical patient suffered a contralateral hemispheric infarct 2 weeks after revascularization; no child treated medically (aspirin) has had a stroke to date. The median follow-up duration was 29.2 months (IQR 21.8–54.0 months) from the date of the first catheter angiogram to last clinic visit.CONCLUSIONSAll children who receive cranial radiation therapy from any source, particularly if the parasellar region was involved and the child was young at the time of treatment, require close surveillance for the development of vasculopathy. A structured and detailed evaluation is necessary to determine optimal treatment.

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Holmes tremor: a delayed complication after resection of brainstem cavernomas

Journal of Neurosurgery ◽

10.3171/2020.7.jns201352 ◽

2020 ◽

pp. 1-11

Author(s):

Marco Cenzato ◽

Davide Colistra ◽

Giorgia Iacopino ◽

Christian Raftopoulos ◽

Ulrich Sure ◽

...

Keyword(s):

Statistical Analysis ◽

Neurophysiological Monitoring ◽

Strict Adherence ◽

Surgical Access ◽

Holmes Tremor ◽

Neurophysiological Studies ◽

Metropolitan Hospital ◽

Delayed Complication ◽

Brainstem Cavernoma ◽

Predicting Factor

OBJECTIVEIn this paper, the authors aimed to illustrate how Holmes tremor (HT) can occur as a delayed complication after brainstem cavernoma resection despite strict adherence to the safe entry zones (SEZs).METHODSAfter operating on 2 patients with brainstem cavernoma at the Great Metropolitan Hospital Niguarda in Milan and noticing a similar pathological pattern postoperatively, the authors asked 10 different neurosurgery centers around the world to identify similar cases, and a total of 20 were gathered from among 1274 cases of brainstem cavernomas. They evaluated the tremor, cavernoma location, surgical approach, and SEZ for every case. For the 2 cases at their center, they also performed electromyographic and accelerometric recordings of the tremor and evaluated the postoperative tractographic representation of the neuronal pathways involved in the tremorigenesis. After gathering data on all 1274 brainstem cavernomas, they performed a statistical analysis to determine if the location of the cavernoma is a potential predicting factor for the onset of HT.RESULTSFrom the analysis of all 20 cases with HT, it emerged that this highly debilitating tremor can occur as a delayed complication in patients whose postoperative clinical course has been excellent and in whom surgical access has strictly adhered to the SEZs. Three of the patients were subsequently effectively treated with deep brain stimulation (DBS), which resulted in complete or almost complete tremor regression. From the statistical analysis of all 1274 brainstem cavernomas, it was determined that a cavernoma location in the midbrain was significantly associated with the onset of HT (p < 0.0005).CONCLUSIONSDespite strict adherence to SEZs, the use of intraoperative neurophysiological monitoring, and the immediate success of a resective surgery, HT, a severe neurological disorder, can occur as a delayed complication after resection of brainstem cavernomas. A cavernoma location in the midbrain is a significant predictive factor for the onset of HT. Further anatomical and neurophysiological studies will be necessary to find clues to prevent this complication.

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Faculty Opinions recommendation of Hemodynamic effects of volume expansion in patients with cardiac tamponade.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1108738.572494 ◽

2008 ◽

Author(s):

Gorazd Voga

Keyword(s):

Cardiac Tamponade ◽

Volume Expansion ◽

Hemodynamic Effects

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Cardiac tamponade from anticoagulant-related spontaneous haemopericardium in a patient with ischaemic cardiomyopathy and heart failure

BMJ Case Reports ◽

10.1136/bcr-2020-238047 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238047

Author(s):

Alicia Lefas ◽

Neil Bodagh ◽

Jiliu Pan ◽

Ali Vazir

Keyword(s):

Heart Failure ◽

Cardiac Tamponade ◽

Ventricular Dysfunction ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Left Ventricular ◽

Heart Failure Therapy ◽

Severe Left Ventricular Dysfunction ◽

Ischaemic Cardiomyopathy ◽

Common Causes

We describe the case of an 86-year-old man with a background of severe left ventricular dysfunction and ischaemic cardiomyopathy who, having been optimised for heart failure therapy in hospital, unexpectedly deteriorated again with hypotension and progressive renal failure over the course of 2 days. Common causes of decompensation were ruled out and a bedside echocardiogram unexpectedly diagnosed new pericardial effusion with tamponade physiology. The patient underwent urgent pericardiocentesis and 890 mL of haemorrhagic fluid was drained. Common causes for haemopericardium were ruled out, and the spontaneous haemopericardium was thought to be related to introduction of rivaroxaban anticoagulation. The patient made a full recovery and was well 2 months following discharge. This case highlights the challenges of diagnosing cardiac tamponade in the presence of more common disorders that share similar non-specific clinical features. In addition, this case adds to growing evidence that therapy with direct oral anticoagulants can be complicated by spontaneous haemopericardium, especially when coadministered with other agents that affect clotting, renal dysfunction and cytochrome P3A5 inhibitors.

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