Postpericardiotomy Syndrome after Cardiac Operations.

Area of Science:

• Cardiology
• Thoracic Surgery
• Immunology

Background:

• Postpericardiotomy syndrome (PPS) is a significant cause of morbidity and mortality following cardiac operations.
• It is characterized by inflammation and fluid accumulation around the heart and lungs after surgery.

Purpose of the Study:

• To systematically review the existing literature on postpericardiotomy syndrome.
• To identify the incidence, common symptoms, and effective management strategies for PPS.

Main Methods:

• Systematic review of published literature on postpericardiotomy syndrome.
• Analysis of patient data regarding timing, symptoms, inflammatory markers, and treatment outcomes.

Main Results:

• PPS typically occurs around 18 days post-cardiac surgery, most frequently after coronary artery bypass grafting and mitral valve replacement.
• Common symptoms include pericardial effusions, pleuritic chest pain, and fever, with elevated inflammatory markers.
• Conservative management was successful in 83.5% of cases, showing a higher recovery rate compared to other interventions.

Conclusions:

• Surgical trauma and cardiopulmonary bypass initiate an inflammatory response leading to PPS.
• Conservative treatment is generally effective, while refractory cases may require corticoids or pericardiectomy.
• Surgical intervention is rarely needed, primarily for cardiac tamponade (2.6% of cases).