Diego Posada-Ríos, Facultad de Medicina, Universidad CES, Medellín, Colombia
Alejandro Ramírez-Moreno, Departamento de Cirugía Cardiovascular, Clínica El Rosario, Medellín, Colombia
Juan C. Jaramillo-González, Departamento de Cirugía Cardiovascular, Clínica El Rosario, Medellín, Colombia
Ricardo Zambrano-Vesga, Servicio de Cardiología y Ecocardiografía, Clínica El Rosario. Medellín, Colombia
Camila Franco-Mesa, Facultad de Medicina, Universidad CES, Medellín, Colombia
Thoracic compartment syndrome in the post operatory of cardiac surgery is a rare entity caused by an increase in pressure within the osteofibrous thoracic cavity. This is due to an increase in the interior volume or a decrease in the space that contains the mediastinal structures. As a result, it leads to a marked decrease in preload and cardiac index causing cardiogenic shock. We present the case of a 86-year-old patient with multiple comorbidities, who underwent aortic valve replacement and reconstruction of the ascending thoracic aorta. Consequently, presented with cardiogenic shock associated to thoracic compartment syndrome in the immediate postoperative period. The patient underwent surgical reintervention twice to relieve cardiogenic shock where the closure of the thoracic cavity was deferred for three days. During that time there was decompression of cardiac cavities and complete recovery of the ventricular function. Thoracic compartment syndrome in the post operatory of cardiac surgery is a rare and potentially lethal condition. It can present in the early or late postoperative period and it requires high clinical suspicion to be diagnosed. Early recognition is crucial in the management and prognosis.
Keywords: Thoracic compartment syndrome. Cardiovascular surgery. Echocardiography
