Decreased incidence of postoperative pericardial effusions after cardiac surgery for congenital heart disease

Prabhu, Anuradha; Ross, Robert D.; Heinert, Maya R.; Walters, Henry L.; Hakimi, Mehdi

doi:10.1016/s0002-9149(97)89218-1

Cited by 19 publications

(13 citation statements)

References 11 publications

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“…3,12 Pericardial effusions have also been observed in 14% of children who underwent surgical procedures for congenital heart conditions. 4 Symptoms of low cardiac output may be variably Early recognition of impending cardiac tamponade is crucial to effecting a good outcome; however, clinical recognition of compromised cardiac filling is often difficult. Symptoms tend to be nonspecific, and manual determination of a pulsus paradoxus, particularly in children, is technically difficult.…”

Section: Discussionmentioning

confidence: 99%

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Detection of Pulsus Paradoxus Associated With Large Pericardial Effusions in Pediatric Patients by Analysis of the Pulse-Oximetry Waveform

2002

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Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Large pericardial effusions may compromise cardiac filling and abruptly precipitate shock. This life-threatening consequence of symptomatic pericardial effusion, cardiac tamponade, necessitates prompt pericardiocentesis.…”

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confidence: 99%

Detection of Pulsus Paradoxus Associated With Large Pericardial Effusions in Pediatric Patients by Analysis of the Pulse-Oximetry Waveform

2002

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“…9 Different ways to grade pericardial effusion [6][7][8][9][10] have been proposed, especially in children [3][4][5][6][7][8][9][10][11][12]14,15 (Table 1).…”

Section: Methodsmentioning

confidence: 99%

“…These included high output from drainage after operation, 6,25 female sex, 6,26 some congenital cardiac operations (such as Fontan-type procedures and atrial septal defect repair) and the incision of the pleura 25,26 and anticoagulation/antiplatelet therapy. [4][5][6]25 In particular, in the early postoperative effusion, continuation of warfarin imposes a high risk, 5 especially if drainage has not been placed yet.…”

Section: Incidence History and Risk Factors Of Postsurgical Pericardmentioning

confidence: 99%

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Controversies in the prophylaxis and treatment of postsurgical pericardial syndromes

Cantinotti

Spadoni

Assanta

et al. 2014

Journal of Cardiovascular Medicine

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Postsurgical pericardial syndromes are common complications after cardiac surgery; however, their treatment is not well established yet. We reviewed the accuracy and limits of clinical trials of prophylaxis and treatment of these diseases to identify an evidence-based therapeutic approach. We performed a literature search in the National Library of Medicine using the keywords pericardial effusion, cardiac surgery and paediatric/congenital. The research was then redefined adding separately the keywords postpericardiotomy syndrome, NSAIDs, steroids and colchicine. We found 12 clinical trials (eight for the prophylaxis and four regarding treatment), testing three major agent classes: NSAIDs, corticosteroids and colchicine. Therapy is generally based on NSAID with or without steroids with the adjunct of colchicine for recurrences. Only a few randomized controlled trials (RCTs) in adults support NSAID therapy. Efficacy of steroids has been proved only in small paediatric works, whereas no studies are available for colchicine. Studies furthermore presented some limitations: not univocal endpoints (not allowing for a meta-analysis), a limited sample size, scarce attention to confounders (such as the underlying cardiac disease and diuretic/analgesic regimen). Moreover, different agents were not assessed, nor when to start therapy. More evidence (two wide RCT plus a meta-analysis) supports the role of colchicine for prophylaxis in adults. Prophylaxis with NSAID/corticosteroids instead failed to have significant advantage in children, whereas a few data are available for adults. Evidence for the treatment of postsurgical pericardial syndromes is incomplete, making it difficult to understand when to treat and which agent to employ, especially in children.

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Pericardial Disease: Etiology, Pathophysiology, Clinical Recognition, and Treatment

Shabetai¹

2007

Cardiovascular Medicine

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Decreased incidence of postoperative pericardial effusions after cardiac surgery for congenital heart disease

Cited by 19 publications

References 11 publications

Detection of Pulsus Paradoxus Associated With Large Pericardial Effusions in Pediatric Patients by Analysis of the Pulse-Oximetry Waveform

Detection of Pulsus Paradoxus Associated With Large Pericardial Effusions in Pediatric Patients by Analysis of the Pulse-Oximetry Waveform

Controversies in the prophylaxis and treatment of postsurgical pericardial syndromes

Pericardial Disease: Etiology, Pathophysiology, Clinical Recognition, and Treatment

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