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Article: Pericardial effusion after open heart surgery for congenital heart disease

TitlePericardial effusion after open heart surgery for congenital heart disease
Authors
Issue Date2003
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
Citation
Heart, 2003, v. 89 n. 7, p. 780-783 How to Cite?
AbstractObjectives: To determine the prevalence and time course of pericardial effusion after open heart surgery for congenital heart diseases and to identify predisposing risk factors. Design and patients: Prospective assessment of development of pericardial effusion in 336 patients (163 males) undergoing open heart surgery for congenital heart disease by serial echocardiography on days 5, 7, 14, 21, and 28 postoperatively. Setting: Tertiary paediatric cardiac centre. Results: The prevalence of pericardial effusion was 23% (77 of 336). Of the 77 patients who developed effusion, 43 (56%) had moderate to large effusions and 18 (23%) were symptomatic. Patients who had a large amount of effusion were more likely to be symptomatic than those with only a small to moderate amount (47.4% v 15.5%, p = 0.01). The mean (SD) onset of pericardial effusion was 11 (7) days after surgery, with 97% (75 of 77) of cases being diagnosed on or before day 28 after surgery. The prevalence of effusion after Fontan-type procedures (60%, 6 of 10) was significantly higher than that after other types of cardiac surgery: repair of left to right shunts (22.1%, 43 of 125), repair of lesions with right ventricular outflow tract obstruction (22.6%, 19 of 84), arterial switch operation (6.7%, 1 of 15), and miscellaneous procedures (25%, 8 of 32) (p = 0.037). Univariate analyses showed that female patients (p = 0.009) and those receiving warfarin (p = 0.002) had increased risk of postoperative pericardial effusion. A greater pericardial drain output in the first four hours after surgery also tended to be significant (p = 0.056). Multivariate logistic regression similarly identified warfarin treatment (β = 1.73, p = 0.009) and female sex (β for male = -0.63, p = 0.037) as significant determinants. Conclusions: Pericardial effusion occurs commonly after open heart surgery for congenital heart disease. Serial echocardiographic monitoring up to 28 days postoperatively is indicated in selected high risk patients such as those with symptoms of postpericardiotomy syndrome and those given warfarin.
Persistent Identifierhttp://hdl.handle.net/10722/42169
ISSN
2014 Impact Factor: 5.595
2014 SCImago Journal Rankings: 2.710
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, EWYen_HK
dc.contributor.authorHo, SAen_HK
dc.contributor.authorTang, KKYen_HK
dc.contributor.authorChau, AKTen_HK
dc.contributor.authorChiu, CSWen_HK
dc.contributor.authorCheung, YFen_HK
dc.date.accessioned2007-01-08T02:30:50Z-
dc.date.available2007-01-08T02:30:50Z-
dc.date.issued2003en_HK
dc.identifier.citationHeart, 2003, v. 89 n. 7, p. 780-783en_HK
dc.identifier.issn1355-6037en_HK
dc.identifier.urihttp://hdl.handle.net/10722/42169-
dc.description.abstractObjectives: To determine the prevalence and time course of pericardial effusion after open heart surgery for congenital heart diseases and to identify predisposing risk factors. Design and patients: Prospective assessment of development of pericardial effusion in 336 patients (163 males) undergoing open heart surgery for congenital heart disease by serial echocardiography on days 5, 7, 14, 21, and 28 postoperatively. Setting: Tertiary paediatric cardiac centre. Results: The prevalence of pericardial effusion was 23% (77 of 336). Of the 77 patients who developed effusion, 43 (56%) had moderate to large effusions and 18 (23%) were symptomatic. Patients who had a large amount of effusion were more likely to be symptomatic than those with only a small to moderate amount (47.4% v 15.5%, p = 0.01). The mean (SD) onset of pericardial effusion was 11 (7) days after surgery, with 97% (75 of 77) of cases being diagnosed on or before day 28 after surgery. The prevalence of effusion after Fontan-type procedures (60%, 6 of 10) was significantly higher than that after other types of cardiac surgery: repair of left to right shunts (22.1%, 43 of 125), repair of lesions with right ventricular outflow tract obstruction (22.6%, 19 of 84), arterial switch operation (6.7%, 1 of 15), and miscellaneous procedures (25%, 8 of 32) (p = 0.037). Univariate analyses showed that female patients (p = 0.009) and those receiving warfarin (p = 0.002) had increased risk of postoperative pericardial effusion. A greater pericardial drain output in the first four hours after surgery also tended to be significant (p = 0.056). Multivariate logistic regression similarly identified warfarin treatment (β = 1.73, p = 0.009) and female sex (β for male = -0.63, p = 0.037) as significant determinants. Conclusions: Pericardial effusion occurs commonly after open heart surgery for congenital heart disease. Serial echocardiographic monitoring up to 28 days postoperatively is indicated in selected high risk patients such as those with symptoms of postpericardiotomy syndrome and those given warfarin.en_HK
dc.format.extent176929 bytes-
dc.format.extent3357 bytes-
dc.format.extent4482 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypetext/plain-
dc.format.mimetypetext/plain-
dc.languageengen_HK
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/en_HK
dc.relation.ispartofHearten_HK
dc.rightsHeart. Copyright © B M J Publishing Group.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCardiac surgical procedures - adverse effectsen_HK
dc.subject.meshHeart defects, congenital - surgeryen_HK
dc.subject.meshPericardial effusion - epidemiology - etiologyen_HK
dc.subject.meshChild, preschoolen_HK
dc.subject.meshEchocardiographyen_HK
dc.titlePericardial effusion after open heart surgery for congenital heart diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1355-6037&volume=89&issue=7&spage=780&epage=783&date=2003&atitle=Pericardial+effusion+after+open+heart+surgery+for+congenital+heart+diseaseen_HK
dc.identifier.emailCheung, YF:xfcheung@hku.hken_HK
dc.identifier.authorityCheung, YF=rp00382en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1136/heart.89.7.780en_HK
dc.identifier.pmid12807856en_HK
dc.identifier.pmcidPMC1767733-
dc.identifier.scopuseid_2-s2.0-0038207138en_HK
dc.identifier.hkuros76931-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038207138&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume89en_HK
dc.identifier.issue7en_HK
dc.identifier.spage780en_HK
dc.identifier.epage783en_HK
dc.identifier.isiWOS:000183505500019-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridCheung, EWY=9432819700en_HK
dc.identifier.scopusauthoridHo, SA=7403713872en_HK
dc.identifier.scopusauthoridTang, KKY=7401589412en_HK
dc.identifier.scopusauthoridChau, AKT=35787094400en_HK
dc.identifier.scopusauthoridChiu, CSW=8714554800en_HK
dc.identifier.scopusauthoridCheung, YF=7202111067en_HK

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