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Incidence and Outcomes of Pericardial Effusion After Congenital Heart Surgery

Mario O'Connor1, Carlos M Mery2, Neil M Venardos3

  • 1Texas Center for Pediatric and Congenital Heart Disease, The University of Texas at Austin Dell Medical School, Austin, TX, USA.

World Journal for Pediatric & Congenital Heart Surgery
|September 9, 2025
PubMed

Insights

Pericardial effusion (PCE) after congenital heart surgery (CHS) occurs in 4% of patients, with higher rates after the Norwood procedure. PCE increases length of stay, mortality, and readmissions, necessitating vigilant monitoring.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Healthcare Informatics

Background:

  • Pericardial effusion (PCE) is a significant postoperative complication following congenital heart surgery (CHS).
  • PCE contributes to complex postoperative care, increased morbidity, and resource utilization.
  • Identifying risk factors for PCE post-CHS is crucial for improving patient outcomes.

Purpose of the Study:

  • To elucidate the risk factors associated with PCE development after CHS.
  • To analyze the impact of PCE on postoperative outcomes, including length of stay, mortality, and readmissions.
  • To identify specific CHS procedures with higher incidences of PCE.

Main Methods:

  • Retrospective analysis of the Pediatric Health Information System Database (2004-2023).
  • Inclusion of patients under 18 who underwent Society of Thoracic Surgeons benchmark procedures.
  • Multivariable analysis to determine adjusted odds of PCE and its associated outcomes.

Main Results:

  • A total of 66,695 surgeries were analyzed, with PCE occurring in 4% of patients.
  • The Norwood procedure showed the highest incidence of PCE (8.9%) and adjusted odds (OR: 2.34).
  • PCE was associated with increased length of stay (16%), mortality (OR: 1.84), and 90-day readmissions (1%). Fontan patients had the highest readmission rate (1.7%).

Conclusions:

  • While the overall incidence of PCE post-CHS is low (4%), specific procedures like the Norwood procedure carry a significantly higher risk (8.9%).
  • PCE presents substantial postoperative challenges, leading to increased mortality and resource utilization.
  • Targeted monitoring and interventions for high-risk patients are essential to mitigate the adverse effects of PCE.

Keywords:
complicationscongenital heart disease (CHD)congenital heart surgerypericardial effusionpericardium (includes everything related)

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