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Pericardial effusion following pulmonary resection.
Yoshito Tomimaru1, Ken Kodama, Jiro Okami
1Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|June 13, 2006
Summary
Postoperative pericardial effusion after pulmonary resection is uncommon but occurs. Early effusions may require drainage, while late effusions can be managed with diuretics, offering an appropriate treatment strategy.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Postoperative pericardial effusion is a known complication of open heart surgery.
- Pericardial effusion following general thoracotomy, such as pulmonary resection, is rarely reported.
Observation:
- This study analyzed eight patients who developed pericardial effusion after pulmonary resection without prior pericardial incision.
- Patients were categorized into two groups based on thoracotomy side and onset timing: left thoracotomy (within 30 days) and right thoracotomy (after 30 days).
Findings:
- Three patients with left thoracotomy presented early (<30 days) and were symptomatic, requiring pericardiotomy or pericardiocentesis.
- Five patients with right thoracotomy presented late (>30 days); three were asymptomatic and treated with diuretics, while two eventually required pericardiocentesis due to progression.
- Conservative treatment with diuretics led to resolution in three of five late-presenting patients within 1-3 months.
Implications:
- A tailored treatment approach for pericardial effusion post-pulmonary resection is suggested.
- Early-onset effusions may benefit from drainage procedures.
- Late-onset effusions can be managed conservatively with diuretics, reserving drainage for progressive cases.