Late tamponade with mechanical circulatory support

Background. Circulatory support with mechanical devices often leads to bleeding and tamponade. Methods. We report a series of three patients that required mechanical circulatory support for postcardiotomy ventricular dysfunction. Results. Late tamponade occurred in each patient with different clinical presentations. Early postoperative bleeding occurred in 2 patients. There was no active bleeding in any of the 3 patients. Transesophageal echocardiography was not helpful in making the diagnosis. Conclusion. Late tamponade, which may be the result of hematoma with earlier bleeding, can present as dyspnea, hypoxia, or forms of hemodynamic collapse. Exploratory media sternotomy is required to definitively make the diagnosis and to evacuate the hematoma. (C) 1998 by The Society of Thoracic Surgeons.