Thorac Cardiovasc Surg 2009; 57(8): 491-493
DOI: 10.1055/s-2008-1039221
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© Georg Thieme Verlag KG Stuttgart · New York

Pneumopericardium and Pneumomediastinum as a Late Complication of Defibrillator Implantation after Coronary Artery Bypass Graft Surgery

M. Parahuleva1 , P. Schifferings1 , C. Neuhof1 , H. Tillmanns1 , A. Erdogan1
  • 1Division of Cardiology and Angiology, Department of Internal Medicine, University Hospital of Giessen and Marburg, Location Giessen, Giessen, Germany
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Publikationsverlauf

received August 1, 2008

Publikationsdatum:
14. Dezember 2009 (online)

Abstract

A 69-year-old male underwent implantation of a cardioverter-defibrillator with cardiac resynchronization therapy (CRT) for symptomatic ventricular tachyarrhythmia (VT) and severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 30 % and dyssynchrony via a left subclavian venous access. Twenty days after the procedure, the patient complained of shortness of breath and was found to have a 30 % apical left pneumothorax on chest X‐ray as a not unusual complication of the subclavian venous access. A computed axial tomography of the chest revealed pneumopericardium and associated pneumomediastinum as a complication of the CRT implantation and persisting microscopic pleuro-pericardial fistula as a consequence of previous coronary artery bypass graft surgery (CABG), accidentally diagnosed three years after the procedure. The pneumothorax and pneumopericardium were small and did not require chest tube placement. The patient was treated conservatively and his subsequent course was excellent.

References

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MD Mariana Parahuleva

Division of Cardiology and Angiology
Department of Internal Medicine
University Hospital of Giessen and Marburg, Location Giessen

Klinikstr. 36

35392 Giessen

Germany

Telefon: + 49 6419942253

Fax: + 49 6419942279

eMail: mariana.parahuleva@innere.med.uni-giessen.de