Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery

Xin Wang

doi:doi:10.11648/j.ccr.20230703.12

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Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery

Xin Wang

Published in Cardiology and Cardiovascular Research (Volume 7, Issue 3)

Received: 30 June 2023 Accepted: 27 July 2023 Published: 5 August 2023

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Abstract

Introduction: Portal hypertension is a serious medical condition associated with fatal gastrointestinal bleeding, liver function abnormalities, and other adverse events. Transjugular intrahepatic portosystemic stent-shunt surgery (TIPSS) has emerged as an effective treatment for alleviating portal hypertension due to its advantages of minimal invasiveness, rapid recovery, and significant therapeutic outcomes. However, the perioperative period of TIPSS is not devoid of risks, and serious complications may arise. Objective: This paper aims to present a case of pericardial tamponade resulting from poor puncture during TIPSS, highlighting the potential life-threatening complications that can occur during this procedure. The management of pericardial tamponade in the perioperative setting is crucial for ensuring perfusion of vital organs and the overall well-being of the patient. Methods: A comprehensive review of the patient's medical records, perioperative notes, and diagnostic imaging was conducted to analyze the circumstances leading to the development of pericardial tamponade following TIPSS. Results: We present a case of a 39-year-old male with portal hypertension who underwent TIPSS as a therapeutic measure. During the procedure, a poor puncture led to the unintended occurrence of pericardial tamponade, causing a rapid deterioration of the patient's hemodynamic status. Immediate recognition of the complication by the anesthesiologist allowed for prompt intervention, with pericardiocentesis performed successfully to alleviate the tamponade and restore cardiac function. Conclusion: Pericardial tamponade following TIPSS is a rare but potentially fatal complication that demands immediate recognition and swift management. This case underscores the significance of close perioperative monitoring and the expertise of the medical team in dealing with unforeseen adverse events during TIPSS. Awareness of such complications can aid in early diagnosis and timely intervention, ultimately contributing to favorable patient outcomes.

Published in	Cardiology and Cardiovascular Research (Volume 7, Issue 3)
DOI	10.11648/j.ccr.20230703.12
Page(s)	57-60
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Portal Hypertension, Transjugular Intrahepatic Portosystemic Stent-Shunt, TIPSS, Pericardial Tamponade, Perioperative Complications, Anesthesiologist

References

[1]	Tripathi D, Stanley A J, Hayes P C, et al. Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension [J]. Gut, 2020, 69 (7): 1173-1192.
[2]	Patidar K R, Sydnor M, Sanyal A J. Transjugular Intrahepatic Portosystemic Shunt [J]. Clinics in Liver Disease, 2014, 18 (4): 853-876.
[3]	Lv Y, Liu N, Li Y, et al. Coagulation Dysfunction in Patients with Liver Cirrhosis and Splenomegaly and Its Countermeasures: A Retrospective Study of 1522 Patients [J]. Disease Markers, 2023, 2023: 1-9.
[4]	DeGasperi A, Corti A, Corso R, et al. Transjugular intrahepatic portosystemic shunt (TIPS): the anesthesiological point of view after 150 procedures managed under total intravenous anesthesia [J]. Journal of Clinical Monitoring and Computing, 2009, 23 (6): 341-346.
[5]	Steib A, Collange O. Anesthesia for other endovascular stenting [J]. Current Opinion in Anesthesiology, 2008, 21 (4): 519-522.
[6]	Scher C. Anesthesia for Transjugular Intrahepatic Portosystemic Shunt [J]. International Anesthesiology Clinics, 2009, 47 (2): 21-28.
[7]	Bello C, Paisansathan C, Riva T, et al. Anesthesia care in the interventional neuroradiology suite: an update [J]. Current Opinion in Anesthesiology, 2022, 35 (4): 457-464.
[8]	Díaz-Gómez J L, Via G, Ramakrishna H. Focused cardiac and lung ultrasonography: implications and applicability in the perioperative period [J]. Romanian Journal of Anesthesia and Intensive Care, 2016, 23 (1): 41-54.
[9]	Andruszkiewicz P, Sobczyk D. Ultrasound in critical care [J]. Anesthesiology Intensive Therapy, 2013, 45 (3): 177-181.
[10]	Haskings E M, Eissa M, Allard R V, et al. Point-of-care ultrasound use in emergencies: what every anesthetist should know [J]. Anesthesia, 2023, 78 (1): 105-118.
[11]	Adamczyk M, Wasilewski J, Niedziela J, et al. Pericardial tamponade as a complication of invasive cardiac procedures: a review of the literature [J]. Postepy W Kardiologii Interwencyjnej = Advances in Interventional Cardiology, 2019, 15 (4): 394-403.
[12]	Messina Alvarez A A, Bilal M A, Manasrah N, et al. Iatrogenic Cardiac Tamponade Secondary to Central Venous Catheter Placement: A Literature Review [J]. Cureus, 2023, 15 (4): e37695.
[13]	Alsenan A K, Al Dhneem H N, Alfandi H A, et al. Iatrogenic Causes of Cardiac Tamponade Resulting From Surgical Procedures: An Overview [J]. Cureus, 2023, 15 (1): e33773.
[14]	Pérez-Casares A, Cesar S, Brunet-Garcia L, et al. Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade [J]. Frontiers in Pediatrics, 2017, 5: 79.
[15]	Guarracino F, Baldassarri R. Transesophageal echocardiography in the OR and ICU [J]. Minerva Anestesiologica, 2009, 75 (9): 518-529.
[16]	Dastmalchian S, Aryafar H, Tavri S. Intravascular Ultrasound Guidance for TIPS Procedures: A Review [J]. AJR. American journal of roentgenology, 2022, 219 (4): 634-646.
[17]	Tripathi D, Redhead D. Transjugular intrahepatic portosystemic stent-shunt: technical factors and new developments [J]. European Journal of Gastroenterology & Hepatology, 2006, 18 (11): 1127-1133.

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APA Style

Xin Wang. (2023). Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery. Cardiology and Cardiovascular Research, 7(3), 57-60. https://doi.org/10.11648/j.ccr.20230703.12

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ACS Style

Xin Wang. Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery. Cardiol. Cardiovasc. Res. 2023, 7(3), 57-60. doi: 10.11648/j.ccr.20230703.12

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AMA Style

Xin Wang. Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery. Cardiol Cardiovasc Res. 2023;7(3):57-60. doi: 10.11648/j.ccr.20230703.12

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@article{10.11648/j.ccr.20230703.12,
  author = {Xin Wang},
  title = {Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery},
  journal = {Cardiology and Cardiovascular Research},
  volume = {7},
  number = {3},
  pages = {57-60},
  doi = {10.11648/j.ccr.20230703.12},
  url = {https://doi.org/10.11648/j.ccr.20230703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20230703.12},
  abstract = {Introduction: Portal hypertension is a serious medical condition associated with fatal gastrointestinal bleeding, liver function abnormalities, and other adverse events. Transjugular intrahepatic portosystemic stent-shunt surgery (TIPSS) has emerged as an effective treatment for alleviating portal hypertension due to its advantages of minimal invasiveness, rapid recovery, and significant therapeutic outcomes. However, the perioperative period of TIPSS is not devoid of risks, and serious complications may arise. Objective: This paper aims to present a case of pericardial tamponade resulting from poor puncture during TIPSS, highlighting the potential life-threatening complications that can occur during this procedure. The management of pericardial tamponade in the perioperative setting is crucial for ensuring perfusion of vital organs and the overall well-being of the patient. Methods: A comprehensive review of the patient's medical records, perioperative notes, and diagnostic imaging was conducted to analyze the circumstances leading to the development of pericardial tamponade following TIPSS. Results: We present a case of a 39-year-old male with portal hypertension who underwent TIPSS as a therapeutic measure. During the procedure, a poor puncture led to the unintended occurrence of pericardial tamponade, causing a rapid deterioration of the patient's hemodynamic status. Immediate recognition of the complication by the anesthesiologist allowed for prompt intervention, with pericardiocentesis performed successfully to alleviate the tamponade and restore cardiac function. Conclusion: Pericardial tamponade following TIPSS is a rare but potentially fatal complication that demands immediate recognition and swift management. This case underscores the significance of close perioperative monitoring and the expertise of the medical team in dealing with unforeseen adverse events during TIPSS. Awareness of such complications can aid in early diagnosis and timely intervention, ultimately contributing to favorable patient outcomes.},
 year = {2023}
}

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TY  - JOUR
T1  - Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery
AU  - Xin Wang
Y1  - 2023/08/05
PY  - 2023
N1  - https://doi.org/10.11648/j.ccr.20230703.12
DO  - 10.11648/j.ccr.20230703.12
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 57
EP  - 60
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20230703.12
AB  - Introduction: Portal hypertension is a serious medical condition associated with fatal gastrointestinal bleeding, liver function abnormalities, and other adverse events. Transjugular intrahepatic portosystemic stent-shunt surgery (TIPSS) has emerged as an effective treatment for alleviating portal hypertension due to its advantages of minimal invasiveness, rapid recovery, and significant therapeutic outcomes. However, the perioperative period of TIPSS is not devoid of risks, and serious complications may arise. Objective: This paper aims to present a case of pericardial tamponade resulting from poor puncture during TIPSS, highlighting the potential life-threatening complications that can occur during this procedure. The management of pericardial tamponade in the perioperative setting is crucial for ensuring perfusion of vital organs and the overall well-being of the patient. Methods: A comprehensive review of the patient's medical records, perioperative notes, and diagnostic imaging was conducted to analyze the circumstances leading to the development of pericardial tamponade following TIPSS. Results: We present a case of a 39-year-old male with portal hypertension who underwent TIPSS as a therapeutic measure. During the procedure, a poor puncture led to the unintended occurrence of pericardial tamponade, causing a rapid deterioration of the patient's hemodynamic status. Immediate recognition of the complication by the anesthesiologist allowed for prompt intervention, with pericardiocentesis performed successfully to alleviate the tamponade and restore cardiac function. Conclusion: Pericardial tamponade following TIPSS is a rare but potentially fatal complication that demands immediate recognition and swift management. This case underscores the significance of close perioperative monitoring and the expertise of the medical team in dealing with unforeseen adverse events during TIPSS. Awareness of such complications can aid in early diagnosis and timely intervention, ultimately contributing to favorable patient outcomes.
VL  - 7
IS  - 3
ER  -

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Author Information

Xin Wang

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China

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Xin Wang. (2023). Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery. Cardiology and Cardiovascular Research, 7(3), 57-60. https://doi.org/10.11648/j.ccr.20230703.12

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ACS Style

Xin Wang. Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery. Cardiol. Cardiovasc. Res. 2023, 7(3), 57-60. doi: 10.11648/j.ccr.20230703.12

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AMA Style

Xin Wang. Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery. Cardiol Cardiovasc Res. 2023;7(3):57-60. doi: 10.11648/j.ccr.20230703.12

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@article{10.11648/j.ccr.20230703.12,
  author = {Xin Wang},
  title = {Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery},
  journal = {Cardiology and Cardiovascular Research},
  volume = {7},
  number = {3},
  pages = {57-60},
  doi = {10.11648/j.ccr.20230703.12},
  url = {https://doi.org/10.11648/j.ccr.20230703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20230703.12},
  abstract = {Introduction: Portal hypertension is a serious medical condition associated with fatal gastrointestinal bleeding, liver function abnormalities, and other adverse events. Transjugular intrahepatic portosystemic stent-shunt surgery (TIPSS) has emerged as an effective treatment for alleviating portal hypertension due to its advantages of minimal invasiveness, rapid recovery, and significant therapeutic outcomes. However, the perioperative period of TIPSS is not devoid of risks, and serious complications may arise. Objective: This paper aims to present a case of pericardial tamponade resulting from poor puncture during TIPSS, highlighting the potential life-threatening complications that can occur during this procedure. The management of pericardial tamponade in the perioperative setting is crucial for ensuring perfusion of vital organs and the overall well-being of the patient. Methods: A comprehensive review of the patient's medical records, perioperative notes, and diagnostic imaging was conducted to analyze the circumstances leading to the development of pericardial tamponade following TIPSS. Results: We present a case of a 39-year-old male with portal hypertension who underwent TIPSS as a therapeutic measure. During the procedure, a poor puncture led to the unintended occurrence of pericardial tamponade, causing a rapid deterioration of the patient's hemodynamic status. Immediate recognition of the complication by the anesthesiologist allowed for prompt intervention, with pericardiocentesis performed successfully to alleviate the tamponade and restore cardiac function. Conclusion: Pericardial tamponade following TIPSS is a rare but potentially fatal complication that demands immediate recognition and swift management. This case underscores the significance of close perioperative monitoring and the expertise of the medical team in dealing with unforeseen adverse events during TIPSS. Awareness of such complications can aid in early diagnosis and timely intervention, ultimately contributing to favorable patient outcomes.},
 year = {2023}
}

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TY  - JOUR
T1  - Intraoperative Pericardial Tamponade During Transjugular Intrahepatic Portosystemic Stent-Shunt Surgery
AU  - Xin Wang
Y1  - 2023/08/05
PY  - 2023
N1  - https://doi.org/10.11648/j.ccr.20230703.12
DO  - 10.11648/j.ccr.20230703.12
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 57
EP  - 60
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20230703.12
AB  - Introduction: Portal hypertension is a serious medical condition associated with fatal gastrointestinal bleeding, liver function abnormalities, and other adverse events. Transjugular intrahepatic portosystemic stent-shunt surgery (TIPSS) has emerged as an effective treatment for alleviating portal hypertension due to its advantages of minimal invasiveness, rapid recovery, and significant therapeutic outcomes. However, the perioperative period of TIPSS is not devoid of risks, and serious complications may arise. Objective: This paper aims to present a case of pericardial tamponade resulting from poor puncture during TIPSS, highlighting the potential life-threatening complications that can occur during this procedure. The management of pericardial tamponade in the perioperative setting is crucial for ensuring perfusion of vital organs and the overall well-being of the patient. Methods: A comprehensive review of the patient's medical records, perioperative notes, and diagnostic imaging was conducted to analyze the circumstances leading to the development of pericardial tamponade following TIPSS. Results: We present a case of a 39-year-old male with portal hypertension who underwent TIPSS as a therapeutic measure. During the procedure, a poor puncture led to the unintended occurrence of pericardial tamponade, causing a rapid deterioration of the patient's hemodynamic status. Immediate recognition of the complication by the anesthesiologist allowed for prompt intervention, with pericardiocentesis performed successfully to alleviate the tamponade and restore cardiac function. Conclusion: Pericardial tamponade following TIPSS is a rare but potentially fatal complication that demands immediate recognition and swift management. This case underscores the significance of close perioperative monitoring and the expertise of the medical team in dealing with unforeseen adverse events during TIPSS. Awareness of such complications can aid in early diagnosis and timely intervention, ultimately contributing to favorable patient outcomes.
VL  - 7
IS  - 3
ER  -

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