Cardiac Tamponade: New Technology Masking an Old Nemesis

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Cardiac Tamponade: New Technology Masking an Old Nemesis Andrew R. Yates, MD, Victoria L. Duffy, BS, RRT, Tamara D. Clark, DNP, Don Hayes, MD, Joseph D. Tobias, MD, Patrick I. McConnell, MD, Thomas J. Preston, BS, CCP The Annals of Thoracic Surgery Volume 97, Issue 3, Pages 1046-1048 (March 2014) DOI: 10.1016/j.athoracsur.2013.06.126 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Hourly patient hemodynamics, with development of tachycardia, hypotension, and elevated central venous pressure. (B) Pump revolutions per minute with maintained extracorporeal membrane oxygenation flow rates and less negative venous/inlet pressure. (C) Decrease in circuit recirculation with increase in patient saturations, decrease in venous saturations, and decrease in end-tidal carbon dioxide (CO2). The Annals of Thoracic Surgery 2014 97, 1046-1048DOI: (10.1016/j.athoracsur.2013.06.126) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Echocardiogram from the apical imaging plane demonstrates extracardiac thrombus resulting in impaired right atrial filling with maintained volume of the right ventricle (RV) and left ventricle (LV). (B) Color flow Doppler demonstrates the high-velocity return from the bicaval double-lumen cannula directed across the tricuspid valve. The Annals of Thoracic Surgery 2014 97, 1046-1048DOI: (10.1016/j.athoracsur.2013.06.126) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 An appropriately positioned bicaval double-lumen catheter with (A) recirculation and with (B) decreased recirculation during tamponade. The Annals of Thoracic Surgery 2014 97, 1046-1048DOI: (10.1016/j.athoracsur.2013.06.126) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions