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Article: Pericardial effusion after open heart surgery for congenital heart disease
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TitlePericardial effusion after open heart surgery for congenital heart disease
 
AuthorsCheung, EWY1
Ho, SA1
Tang, KKY1
Chau, AKT1
Chiu, CSW1
Cheung, YF1
 
Issue Date2003
 
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
 
CitationHeart, 2003, v. 89 n. 7, p. 780-783 [How to Cite?]
DOI: http://dx.doi.org/10.1136/heart.89.7.780
 
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.
 
ISSN1355-6037
2012 Impact Factor: 5.014
2012 SCImago Journal Rankings: 2.052
 
DOIhttp://dx.doi.org/10.1136/heart.89.7.780
 
PubMed Central IDPMC1767733
 
ISI Accession Number IDWOS:000183505500019
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorCheung, EWY
 
dc.contributor.authorHo, SA
 
dc.contributor.authorTang, KKY
 
dc.contributor.authorChau, AKT
 
dc.contributor.authorChiu, CSW
 
dc.contributor.authorCheung, YF
 
dc.date.accessioned2007-01-08T02:30:50Z
 
dc.date.available2007-01-08T02:30:50Z
 
dc.date.issued2003
 
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.
 
dc.description.naturepublished_or_final_version
 
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.identifier.citationHeart, 2003, v. 89 n. 7, p. 780-783 [How to Cite?]
DOI: http://dx.doi.org/10.1136/heart.89.7.780
 
dc.identifier.doihttp://dx.doi.org/10.1136/heart.89.7.780
 
dc.identifier.epage783
 
dc.identifier.hkuros76931
 
dc.identifier.isiWOS:000183505500019
 
dc.identifier.issn1355-6037
2012 Impact Factor: 5.014
2012 SCImago Journal Rankings: 2.052
 
dc.identifier.issue7
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC1767733
 
dc.identifier.pmid12807856
 
dc.identifier.scopuseid_2-s2.0-0038207138
 
dc.identifier.spage780
 
dc.identifier.urihttp://hdl.handle.net/10722/42169
 
dc.identifier.volume89
 
dc.languageeng
 
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofHeart
 
dc.relation.referencesReferences in Scopus
 
dc.rightsHeart. Copyright © B M J Publishing Group.
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshCardiac surgical procedures - adverse effects
 
dc.subject.meshHeart defects, congenital - surgery
 
dc.subject.meshPericardial effusion - epidemiology - etiology
 
dc.subject.meshChild, preschool
 
dc.subject.meshEchocardiography
 
dc.titlePericardial effusion after open heart surgery for congenital heart disease
 
dc.typeArticle
 
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<contributor.author>Ho, SA</contributor.author>
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<contributor.author>Chiu, CSW</contributor.author>
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Author Affiliations
  1. The University of Hong Kong