normalpericardialphysiologyandtonadephysiology-nt正常心包填塞生理學(xué)和生理學(xué)n-文庫吧資料
2025-01-18 07:35本頁面
【正文】 AbNormal MMode Persistance of this separation beyond the rapid filling phase of the LV is suggestive of abnormal increase in pericardial fluid PostCABG pericardial effusion Seen in approximately 85% of patients In 93% has peaked by the 10th post operative day Loculated effusion Seen post CABG Recurrent pericardial disease Percutaneous drainage may not be possible A small loculation in the right place can be hemodynamically significant Loculated effusion Loculated effusion can be difficult to assess in certain locations Atrial region, where the effusion itself may be mistaken for normal cardiac chamber Effect of positional change on Pericardial Fluid Distribution Moderate and large effusions are redistributed toward the cardiac apex after two minutes in the sitting position This does not occur with smaller effusions, or with loculated effusions Documentation of apical shift may be useful in demonstrating absence of loculation Loculated Hematomas Localized pericardial hematoma may occur after CABG, Cardiac laceration, or Rupture Postop Loculated Hematomas Postop collection of blood is often localized anterior and lateral to the RA free wall, but may be found anywhere around the heart Chamber pression is particularly mon when the hematomas abut the atria Loculated Hematomas The appearance of the hematoma depends on the extent of thrombus formation: Echo free space High
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