Graft Anastomotic Bleeding Detected With Transesophageal Echocardiography After Coronary Artery Bypass Grafting: A Case Report

Cardiac tamponade is a severe complication that occurs in 0.8% to 4.9% of cardiac surgeries and 0.2% of coronary artery bypass graft (CABG) surgeries. A 74-year-old woman developed cardiac tamponade 5 hours after on-pump arrested heart CABG. Transesophageal echocardiography (TEE) showed left atrial compression and ventricular diastolic collapse from pericardial hemorrhage. TEE revealed fresh hemopericardial effusion at the saphenous vein graft (SVG) and right posterior lateral branch (RPL) anastomosis, with small jets from the anastomosis site. TEE effectively identified anastomotic bleeding as the cause, aiding the surgical strategy during reexploration.