The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 787-792, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Pericardial tamponade and its effect on cardiac performance in absence of the pulmonic valve
S Milo, G Salem, I David, A Smolinsky and DA Goor
A controlled study was undertaken to quantitate and compare the amount of
accumulated pericardial fluid causing acute pericardial tamponade in
animals with or without an intact pulmonary valve. In 13 mongrel dogs,
acute pericardial tamponade was induced by gradual loading of the
pericardial cavity with fluid (mean 21.3 cc/m2). In 10 dogs (Group A) the
pulmonic valve was completely excised under caval occlusion and the
pericardium resealed. In Group B, the control group (n = 3), caval
occlusion was performed for the same period of time but the pulmonary valve
was left intact. Reloading of the pericardium with fluid in both groups
revealed that whereas in the Control Group B a similar volume of fluid was
required (mean 213 cc/m2) to cause critical tamponade, in Group A a much
smaller volume (mean 132 cc/m2) (40% decrease) now produced tamponade (p
less than 0.001). The results of the study may have important practical
implications in patients having cardiac operations in which the pulmonary
valve is left incompetent, such as after complete repair of tetralogy of
Fallot.
