| Pericardial effusion after open heart surgery for congenital heart disease. | |
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MedLine Citation:
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PMID: 12807856 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine the prevalence and time course of pericardial effusion after open heart surgery for congenital heart diseases and to identify predisposing risk factors. DESIGN AND PATIENTS: Prospective assessment of development of pericardial effusion in 336 patients (163 males) undergoing open heart surgery for congenital heart disease by serial echocardiography on days 5, 7, 14, 21, and 28 postoperatively. SETTING: Tertiary paediatric cardiac centre. RESULTS: The prevalence of pericardial effusion was 23% (77 of 336). Of the 77 patients who developed effusion, 43 (56%) had moderate to large effusions and 18 (23%) were symptomatic. Patients who had a large amount of effusion were more likely to be symptomatic than those with only a small to moderate amount (47.4% v 15.5%, p = 0.01). The mean (SD) onset of pericardial effusion was 11 (7) days after surgery, with 97% (75 of 77) of cases being diagnosed on or before day 28 after surgery. The prevalence of effusion after Fontan-type procedures (60%, 6 of 10) was significantly higher than that after other types of cardiac surgery: repair of left to right shunts (22.1%, 43 of 195), repair of lesions with right ventricular outflow tract obstruction (22.6%, 19 of 84), arterial switch operation (6.7%, 1 of 15), and miscellaneous procedures (25%, 8 of 32) (p = 0.037). Univariate analyses showed that female patients (p = 0.009) and those receiving warfarin (p = 0.002) had increased risk of postoperative pericardial effusion. A greater pericardial drain output in the first four hours after surgery also tended to be significant (p = 0.056). Multivariate logistic regression similarly identified warfarin treatment (beta = 1.73, p = 0.009) and female sex (beta for male = -0.63, p = 0.037) as significant determinants. CONCLUSIONS: Pericardial effusion occurs commonly after open heart surgery for congenital heart disease. Serial echocardiographic monitoring up to 28 days postoperatively is indicated in selected high risk patients such as those with symptoms of postpericardiotomy syndrome and those given warfarin. |
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Authors:
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E W Y Cheung; S A Ho; K K Y Tang; A K T Chau; C S W Chiu; Y F Cheung |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 89 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-06-16 Completed Date: 2003-07-14 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 780-3 Citation Subset: AIM; IM |
Affiliation:
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Division of Paediatric Cardiology, Grantham Hospital, The University of Hong Kong, Hong Kong, People's Republic of China. xfcheung@hkucc.hku.hk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Cardiac Surgical Procedures / adverse effects* Causality Child, Preschool Echocardiography Female Heart Defects, Congenital / surgery* Humans Male Pericardial Effusion / epidemiology, etiology* Postoperative Care Prevalence Prospective Studies Risk Factors Sex Factors |
| Comments/Corrections | |
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