• Chi-Hsiang Huang, Yi Chang, Wing-Sum Chan, Anne Chao, Hui-Hsun Huang, and Gong-Jhe Wu.
• Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
• Acta Anaesthesiol Taiwan. 2005 Mar 1; 43 (1): 39-42.

AbstractProximal aortic dissection is frequently associated with cardiac tamponade. The treatment sometimes is difficult. We present a 69-year-old female patient who after repeated episodes of syncope received an open drainage of pericardial effusion that ended in a fatal outcome. She was also known to have mural thrombi in the aorta. However, preanesthetic trransesophageal echocardiography revealed besides pericardial effusion, also dilatation of aortic root which compressed both atria. She developed sudden cardiovascular collapse following drainage of pericardial effusion to which she succumbed in spite of vigorous resuscitation. We suggest that the patients with cardiac tamponade complicated by aortic dissection must receive direct aortic repair together with intraoperative pericardial drainage. Selective or single pericardiocentesis should better be avoided.

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