Delayed Cardiac Tamponade after the Nuss Procedure for Pectus Excavatum: A Case Report and Simple Management
DOI:
https://doi.org/10.1532/HSF98.20071217Abstract
A 22-year-old man presented at our emergency department with clinical signs of cardiac tamponade that required emergency surgery. We treated this patient by using emergency echocardiographically guided pericardiocentesis with insertion of a central venous catheter for drainage without removal of the steel bar. The causes of his pericardial effusion appeared to have been displacement of the bar from a pectus excavatum repair 6 months previously and his ingestion of ginseng extract. This case illustrates a possible cause of cardiac tamponade after the Nuss procedure and a simple way to manage it.References
Ang-Lee MK, Moss J, Yuan CS. 2001. Herbal medicines and perioperative care. JAMA 286:208-16.nHorneffer PJ, Miller RH, Pearson TA, Rykiel MF, Reitz BA, Gardner TJ. 1990. The effective treatment of postpericardiotomy syndrome after cardiac operations: a randomized placebo-controlled trial. J Thorac Cardiovasc Surg 100:292-6.nLeonhardt J, Kubler JF, Feiter J, Ure BM, Petersen C. 2005. Complications of the minimally invasive repair of pectus excavatum. J Pediatr Surg 40:e7-9.nMaisch B, Seferovi? PM, Risti? AD, et al. 2004. Guidelines on the diagnosis and management of pericardial diseases executive summary: The Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology. Eur Heart J 25:587-610.nNuss D, Croitoru DP, Kelly RE Jr, Goretsky MJ, Nuss KJ, Gustin TS. 2002. Review and discussion of the complications of minimally invasive pectus excavatum repair. Eur J Pediatr Surg 12:230-4.nOng CC, Choo K, Morreau P, Auldist A. 2005. The learning curve in learning the curve: a review of Nuss procedure in teenagers. ANZ J Surg 75:421-4.nPark HJ, Lee JH, Song YB, Park KH. 1996. Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. Biol Pharm Bull 19:1434-9.nSpodick DH. 2001. Pericardial diseases. In: Braunwald E, Zipes DP, Libby P, eds. Heart disease: a textbook of cardiovascular medicine. 6th ed. Vol. 2. Philadelphia, Pa: W.B. Saunders. p 1823-76.nTeng CM, Kuo SC, Ko FN, Lee JC, Lee LG, Chen SC. 1989. Antiplatelet actions of panaxynol and ginsenosides inolated from ginseng. Biochim Biophys Acta 990:315-20.nTsang TS, Freeman WK, Barnes ME, Reeder GS, Packer DL, Seward JB. 1998. Rescue echocardiographically guided pericardiocentesis for cardiac perforation complicating catheter-based procedures: the Mayo Clinic experience. J Am Coll Cardiol 32:1345-50.n
