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Published on: May 26, 2023
Pericardial effusion after pediatric cardiac surgeries: a single center observation
Mohammad Dalili1, Hassan Zamani2, Mohammadyousef Aarabi-Moghaddam1
1Department of Pediatric Cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Insights
Pericardial effusion (PE) occurs in about 10% of pediatric cardiac surgeries, often within 13 days. Low-dose aspirin and corticosteroids effectively treat this common complication.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Pericardial Diseases
Background:
- Fibrinous pericarditis is a known reaction post-pericardiotomy.
- Inflamed pericardium can fuse to the sternum within days of surgery.
Purpose of the Study:
- To assess the prevalence of pericardial effusion (PE) after pediatric cardiac surgery.
- To identify risk factors, time course, and treatment responses for PE.
Main Methods:
- Prospective assessment of 486 children undergoing cardiac surgery for congenital heart diseases.
- Serial echocardiography used to monitor PE occurrence.
- Clinical manifestations and therapy responses were analyzed.
Main Results:
- PE prevalence was approximately 10% across all cardiac surgeries.
- Higher PE prevalence (29%) observed after Fontan-type procedures and AVSD repair.
- Mean onset of PE was 11 days post-surgery; 87% diagnosed by day 13.
- Aspirin effective in 77%, prednisone in 90% of cases.
Conclusions:
- Pericardial effusion can develop weeks after cardiac surgery.
- PE is not uncommon after palliative cardiac surgeries.
- Low-dose aspirin and corticosteroids are generally effective treatments.
Background:
Development of fibrinous pericarditis after pericardiotomy is a well-recognized reaction. Within a few post-operative days, the inflammated surface of pericardium begins to fuse to the overlying sternum.
Objectives:
Our aim was to assess the prevalence, risk factors, time course and therapy response of pericardial effusion (PE) after cardiac surgeries in children.
Patients And Methods:
PE occurrence was assessed prospectively in 486 children who underwent cardiac surgery for congenital heart diseases by serial echocardiography. Clinical manifestations were observed and response to different therapies was analyzed.
Results:
The prevalence of PE was about 10% for all cardiac surgeries. Symptoms were exclusively seen in patients who had moderate to large effusions. The mean onset of pericardial effusion was 11 (± 8) days after surgery procedure, with 87 % (42 of 48) of cases being diagnosed on or before day 13 after operation. The prevalence of effusion after Fontan-type procedures and AVSD repair (29 %, 5 of 17 for both) was significantly higher than other types of cardiac surgeries. Aspirin administration was effective in 77 % and prednisone in 90 % of the cases.
Conclusions:
PE may be developed as late as weeks after cardiac surgeries. PE after palliative cardiac surgeries is not uncommon. Low doses of aspirin and corticosteroids are usually effective for treating this complication.
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