What is included in surgical care for hemodynamically unstable cardiac tamponade?

Updated: Nov 28, 2018
  • Author: Chakri Yarlagadda, MD, FACC, FSCAI, FASNC, CCDS; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

For a hemodynamically unstable patient or one with recurrent tamponade, provide care as described below.

Surgical creation of a pericardial window

This involves the surgical opening of a communication between the pericardial space and the intrapleural space. This is usually a subxiphoid approach, with resection of the xiphoid. However, a left paraxiphoid approach with preservation of the xiphoid has been described. [25]

Open thoracotomy and/or pericardiotomy [5] may be required in some cases, and these should be performed by an experienced surgeon.


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