Korean J Anesthesiol.  2014 Jan;66(1):71-74. 10.4097/kjae.2014.66.1.71.

Isolated central venous pressure elevation caused by hematoma formation compressing the superior vena cava following a Bentall operation: a case report

• Song Y
• Sim J
• Seo SJ
• Choi SA
• Shim JK

• KMID: 2237248
• DOI: http://doi.org/10.4097/kjae.2014.66.1.71

Abstract

We present a case of a patient exhibiting isolated elevation of the central venous pressure with minimal hemodynamic deterioration in an immediate postoperative period after Bentall operation requiring re-exploration. Isolated elevation of the central venous pressure usually alerts physicians of a volume overload or right ventricular dysfunction. However, even in the absence of significant hemodynamic deterioration, the development of loculated hematoma that compresses the superior vena cava should be ruled out, as it can be life-threatening through the formation of cerebral and laryngeal edema, similar to superior vena cava syndrome. This case emphasizes the importance of a prompt differential diagnosis of the isolated central venous pressure elevation after cardiac surgery with transesophageal echocardiography for the administration of appropriate treatment.

Keyword

Cardiac surgical procedures; Central venous pressure; Hematoma; Transesophageal echocardiography

MeSH Terms

Cardiac Surgical Procedures
Central Venous Pressure*
Diagnosis, Differential
Echocardiography, Transesophageal
Hematoma*
Hemodynamics
Humans
Laryngeal Edema
Postoperative Period
Superior Vena Cava Syndrome
Thoracic Surgery
Vena Cava, Superior*
Ventricular Dysfunction, Right