Constrictive pericarditis as a complication of cardiac surgery: Recognition of an entity

Kutcher, Michael A.; King, Spencer B.; Alimurung, Benjamin N.; Graver, Joseph M.; Logue, R. Bruce

doi:10.1016/0002-9149(82)91228-0

Cited by 91 publications

(31 citation statements)

References 25 publications

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“…1 A 1982 study reviewing over 5000 cardiac surgery patients estimated a 0.2% incidence of postoperative pericarditis. 2 Although the etiology of pericardial constriction includes infection, trauma, radiation, and neoplasm, it has been suggested that postoperative constrictive pericarditis is related to irritation and subsequent adhesion formation from intraoperative blood loss in contact with an injured serosal surface. 3 A more recent study reviewing 133 heart transplant recipients revealed 12% of patients developed post operative complications, primarily involving the mediastinum and pericardium.…”

Section: Discussionmentioning

confidence: 99%

Noninfectious constrictive pericarditis in a heart transplant recipient

Ramana

Gudmundsson

Maszak

et al. 2005

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

Noninfectious constrictive pericarditis in a heart transplant recipient

Ramana

Gudmundsson

Maszak

et al. 2005

The Journal of Heart and Lung Transplantation

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“…12 Although constrictive pericarditis is conventionally regarded as a particularly rare phenomenon after heart transplantation, one series reports a relatively higher incidence (1.5%). 13 The cited reasons for this increase included recurrent pericardial effusions and the development of mediastinitis or other thoracic infections after heart transplantation.…”

Section: Constrictive Pericarditis After Cardiac Transplantationmentioning

confidence: 99%

Constrictive Pericarditis After Cardiac Transplantation: A Case Report and Literature Review

Kumar

Entrikin

Ntim

et al. 2008

The Journal of Heart and Lung Transplantation

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“…Heart surgery is traumatic, with intraoperative irritation of the pericardial layers by physical manipulation of the heart and from the saline solution. 5 Pericardial irrigation with chemical irritants, such as povidone-iodine solution, may also lead to serosal injury and has been associated with constriction. 6 We used only saline for pericardial irrigation, and neither povidone-iodine or antibiotics was used.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Patients With Constrictive Pericarditis After Coronary Bypass Surgery

et al. 2001

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onstrictive pericarditis (CP) is a well-recognized, but rare, complication of open-heart surgery that was first reported in 1972 after coronary artery bypass grafting (CABG). 1 Since then, there have been isolated case reports of CP as a sequela of CABG. The incidence of CP is estimated to be 0.2-0.3%, 2 but once it develops medical treatment is not effective because of the low cardiac output caused by the limitation of diastolic filling of the left ventricle. Although pericardiectomy is recommended, it has a degree of risk and may not necessarily give a good long-term result. We reviewed the clinical characteristics of patients with CP after CABG to ascertain the risk factors for its development. MethodsFrom January 1989 through March 1999, 463 patients underwent isolated CABG with cardiopulmonary bypass. All patients were subjected to mild hypothermia or normothermia, established by ascending aorta cannulation and single venous cannulation through a median sternotomy. Cardiac arrest was achieved with crystalloid cardioplegic solution infusion, and the heart was cooled with topical ice slush. After weaning from the bypass, the pericardial cavity was irrigated with saline solution alone. Neither antibiotics or povidone-iodine solution was used. The pericardium was left open, and chest tubes were placed in the anterior mediastinum and pericardial cavity prior to chest closure. After surgery, 2-dimensional echocardiography was routinely performed on postoperative days 7-10, and the amount of pericardial effusion was monitored. Patients with dilated saphenous vein grafts or a small coronary artery had oral warfarin therapy, which was started immediately after removal of the chest tubes. Cardiac catheterization and coronary angiography were also performed during postoperative week 2. When the pericardial effusion was moderate or severe, the first choice of treatment was non-steroidal anti-inflammatory agents and an increased dose of diuretics. If these treatments did not reduce the effusion, the second treatment choice was corticosteroids or pericardial drainage. Once CP was clinically suspected during the follow-up period, cardiac catheterization was again performed, in addition to computed tomography (CT) scanning, in order to establish the diagnosis. Statistical AnalysisThe data are reported as means ± standard deviation. Each group was compared univariately with chi-squared and Fisher's exact tests for categorical variables, and the Student's t test for continuous variables. Multiple logistic regression analysis was performed to identify the risk factors for the development of CP. A p value less than 0.05 were considered to be statistically significant. ResultsThe mean follow-up period was 54±31 months (maximum, 112 months) and the follow-up rate was 97%. Of the 463 patients who underwent CABG, 11 (2.4%) developed postoperative CP (8 males, 3 females; mean age, 65 years, Jpn Circ J 2001; 65: 480 -482 (Received January 12, 2001; revised manuscript received February 16, 2001; accepted February 26, 2001 Constric...

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Constrictive pericarditis as a complication of cardiac surgery: Recognition of an entity

Cited by 91 publications

References 25 publications

Noninfectious constrictive pericarditis in a heart transplant recipient

Noninfectious constrictive pericarditis in a heart transplant recipient

Constrictive Pericarditis After Cardiac Transplantation: A Case Report and Literature Review

Clinical Characteristics of Patients With Constrictive Pericarditis After Coronary Bypass Surgery

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