LAUSR

Computed tomography demonstrated a solid softtissue density in the right aspect of the pericardium, significantly compressing the right atrium, measuring 9.1× 7.4cm in diameter (Fig. 1). Transthoracic echocardiography showed a good systolic function, a well-functioning aortic valve prothesis and a mass compressing the right atrium (Video 1). The patient underwent transoesophageal echocardiographyguided video-assisted thoracoscopic surgery and the pathology revealed that it was a localised haematoma. The haematoma was successfully drained, and the patient’s symptoms resolved afterwards (Video 2). Haemopericardium secondary to warfarin can occur in patients presenting with pericarditis, coagulopathy or trauma. However, it is extremely rare to occur spontaneously. Usually it presents as circumferential effusion, unlike our patient who presented with a localised haematoma [1]. Haemopericardium is a well-known complication in the early postoperative phase after heart surgery, but in our patient it presented 35 years after aortic valve replacement.