Postoperative Cardiac Tamponade Produced by Thymic Hematoma

Cardiac tamponade may be encountered during the early postoperative period following open heart operations, and is a surgical emergency necessitating immediate reoperation. In such patients, there is usually an excessive amount of postoperative bleeding, accompanied by widening of the mediastinal shadow on chest roentgenogram, progressive elevation of the central venous pressure, and systemic hypotension becoming progressively more severe and less responsive to treatment. This sequence may ensue even though a large communication between the pericardial and pleural spaces was created at the time of operation, and is usually the result of an accumulation of blood and clot restricting cardiac filling. We have recently observed a child, however, in whom the clinical features of cardiac tamponade occurred following correction of the pentalogy of Fallot, and resulted from hemorrhage into the thymus gland. This cause for postoperative cardiac tamponade has apparently not been previously described.

Report of a Case  An 8-year-old girl