CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1595842
This article is part of the Research TopicExploring New Frontiers in Heart Surgery: Case Studies 2025View all 10 articles
Application of Controlled Pericardial Drainage in Type A Aortic Dissection Complicated by Cardiac Tamponade
Provisionally accepted
Yixin He
Ying Yang*- Emergency Department, Shenzhen Hospital, Peking University, Shenzhen, Beijing Municipality, China
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Background: Type A aortic dissection (TAAD), when complicated by cardiac tamponade, represents a life-threatening cardiovascular emergency. Acute pericardial effusion critically compromises cardiac function. Though emergent surgical repair remains the gold standard, preoperative hemodynamic instability substantially heightens surgical risk. Controlled pericardial drainage (CPD) has been proposed as a bridging intervention to rapidly relieve tamponade symptoms while mitigating complications associated with excessive drainage. However, its clinical utility remains controversial because of concerns that post-drainage blood pressure elevation may accelerate dissection progression or precipitate rupture. This case report highlights the successful use of CPD to stabilize a patient with TAAD and cardiac tamponade, facilitating safe transition to definitive surgery, and discusses the clinical utility of this strategy.Case presentation: A 48-year-old man presented to the emergency department with an acute onset of altered mental status lasting for 50 min. Bedside ultrasound and aortic computed tomography angiography confirmed a TAAD diagnosis complicated by pericardial tamponade. After the examination, the patient experienced sudden hypotension, which was promptly managed with emergency CPD, resulting in rapid blood pressure recovery. Subsequently, the patient underwent "Sun's procedure" and artificial vascular replacement, during which 500 ml of pericardial blood was extracted. The patient recovered and was discharged 24 days after the surgery.Conclusion: Under rigorous hemodynamic monitoring and within a multidisciplinary framework, CPD effectively functions as a preoperative stabilization approach in patients with TAAD complicated with pericardial tamponade, thereby securing valuable time for subsequent surgical interventions.
Keywords: Controlled Pericardial Drainage, aortic dissection, Cardiac Tamponade, Bedside echocardiography, Computed Tomography Angiography (CTA)
Received: 18 Mar 2025; Accepted: 08 Jul 2025.
Copyright: © 2025 He and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ying Yang, Emergency Department, Shenzhen Hospital, Peking University, Shenzhen, 518036, Beijing Municipality, China
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