A Rescue Case of Coronary Artery Rupture after Video-Assisted Thoracic Surgery

(Department of Cardiovascular Surgery, Sunagawa City Medical Center, Sunagawa, Japan)

Akihiko Sasaki Masahiro Miyajima Shinji Nakashima
A 64-year-old man had a history of interstitial pneumonia and emphysema since 2000. He underwent video-assisted thoracic surgery (VATS) for lung carcinoma at another hospital on June 30, 2003. Because he suddenly suffered anterior chest pain with shock in September 11 2003, he came to our emergency room. His blood pressure showed 90mmHg, his consciousness level was drowsy and it changed to shock status. Cardiac tamponade was diagnosed by cardiac echography showing an echo-free space and pericardiocentesis was carried out for urgent management of acute tamponade. After the removal of pericardial effusion, his consciousness and blood pressure returned to a normal level. As pericardial blood effusion was continued without aortic dissection by CT, we performed an emergency operation. We set up an external cardiac bypass immediately and removed a massive hematoma weighing 422g, we colud then find the ruptured circumflex coronary artery with a small hole of pericardium penetrating the left pleural space and repaired that ruptured coronary artery during cardiac arrest. His postoperative course was uneventful, and he was discharged on October 6.
@Jpn. J. Cardiovasc. Surg. 37: 65-68 (2008)