Surgical closure is necessary for perforations that demonstrate continued bleeding despite minimal invasive therapy, refractory [[ischemia]], or recurrent [[hemorrhage]].
==Is Treatment Working?==
There are several signs that indicate whether treatment is failing. Incomplete closure is signified by persistent dye extravasation, while [[pericardial]] fluid collection and impending cardiac [[tamponade]] is signified by increasing right atrial pressure. Peristent fluid accumulation or pericardial drain output (>24 h) should prompt surgical repair.
Serial echocardiography should be performed q 6-12h.
Revision as of 13:19, 25 October 2011
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