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Pericardial effusion after congenital heart surgery
Mio Noma1, Yasutaka Hirata2,3, Norimichi Hirahara4
1Department of Cardiovascular Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
JTCVS Open
|August 25, 2022
Summary
Postoperative pericardial effusion after congenital heart surgery affects 1.4% of patients. Key risk factors include trisomy 21, 22q.11 deletion, first-time surgery, and blood transfusion.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Medical Informatics
Background:
- Pericardial effusion is a significant complication following cardiac surgery, impacting patient morbidity and mortality.
- Identifying risk factors for pericardial effusion after congenital heart surgery is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze risk factors associated with pericardial effusion after congenital heart surgery.
- To identify predictors for the development of pericardial effusion in this patient population.
Main Methods:
- Retrospective cohort study utilizing data from the Japan Congenital Cardiovascular Surgery Database (2008-2016).
- Inclusion of 64,777 patients undergoing congenital heart surgery.
- Univariable and multivariable regression analyses were performed to identify risk factors.
Main Results:
- The incidence of postoperative pericardial effusion was 1.4% (909 patients).
- Independent risk factors identified: trisomy 21 (OR, 1.54), 22q.11 deletion (OR, 2.17), first-time cardiac surgery (OR, 2.01), and blood transfusion (OR, 1.43).
- Lower risk was associated with neonates, infants, VSD repair, ASD repair, TOF repair, and arterial switch operations.
Conclusions:
- Postoperative pericardial effusion occurred in 1.4% of patients undergoing congenital cardiac surgery.
- Trisomy 21, 22q.11 deletion, first-time surgery, and blood transfusion are key predictors for pericardial effusion.
- Understanding these risk factors can guide preventative strategies and management.
Keywords:
22q.11 deletionASD, atrial septal defectCPB, cardiopulmonary bypassJCCVSD, Japan Congenital Cardiovascular Surgery DatabaseOR, odds ratioPA, pulmonary arteryPE, pericardial effusionPPS, postpericardiotomy syndromeTOF, tetralogy of FallotVSD, ventricular septal defectblood transfusioncongenital heart surgeryfirst-time surgerypostoperative pericardial effusionpostpericardiotomy syndrometrisomy 21
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