Pericardial effusion after congenital heart surgery

Noma, Mio; Hirata, Yasutaka; Hirahara, Norimichi; Suzuki, Takaaki; Matsubara, Hiroaki; Hiramatsu, Yuji; Yoshimura, Yukihiro; Takamoto, Shinichi

doi:10.1016/j.xjon.2022.01.001

Cited by 2 publications

(6 citation statements)

References 27 publications

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“…This is similar to previous reports of PCE after ASO ranging from 0.0% to 6.7%. 9 , 11 , 12 There were multiple morbidities associated with PCE, including pleural effusion and MCS, despite not knowing the exact temporal associations with PCE. Although there was no association with mortality, PCE was associated with a longer postoperative LOS.…”

Section: Commentmentioning

confidence: 99%

“…However, our analysis was limited by the inability to look at individual intraoperative technical and procedural components such as surgical approach, anesthesia duration, cardiopulmonary bypass strategy, and mediastinal chest tube management. 9 , 10 …”

Section: Commentmentioning

confidence: 99%

“…[5][6][7][8] Reported prevalence of postoperative PCE ranges from 1.1% to 65%, with cardiopulmonary bypass time, atrial septal defect (ASD) repair, genetic abnormalities, and first-time cardiac surgery having been identified as independent risk factors. [9][10][11][12][13][14] However, these published studies are limited to mostly singlecenter reports encompassing various congenital heart disease (CHD) subtypes and surgeries, making the meaningful extrapolation to individual populations difficult. Additionally, hindering PCE research is the lack of standardized approach to identification or severity classification.…”

Section: Introductionmentioning

confidence: 99%

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Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review

Mikulski

Well

Subramanian

et al. 2023

World J Pediatr Congenit Heart Surg

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Background: Pericardial effusion (PCE) is a significant complication after pediatric cardiac surgery. This study investigates PCE development after the arterial switch operation (ASO) and its short-term and longitudinal impacts. Methods: A retrospective review of the Pediatric Health Information System database. Patients with dextro-transposition of the great arteries who underwent ASO from January 1, 2004, to March 31, 2022, were identified. Patients with and without PCE were analyzed with descriptive, univariate, and multivariable regression statistics. Results: There were 4896 patients identified with 300 (6.1%) diagnosed with PCE. Thirty-five (11.7%) with PCE underwent pericardiocentesis. There were no differences in background demographics or concomitant procedures between those who developed PCE and those who did not. Patients who developed PCE more frequently had acute renal failure (N = 56 (18.7%) vs N = 603(13.1%), P = .006), pleural effusions (N = 46 (15.3%) vs N = 441 (9.6%), P = .001), mechanical circulatory support (N = 26 (8.7%) vs N = 199 (4.3%), P < .001), and had longer postoperative length of stay (15 [11-24.5] vs 13 [IQR: 9-20] days). After adjustment for additional factors, pleural effusions (OR = 1.7 [95% CI: 1.2-2.4]), and mechanical circulatory support (OR = 1.81 [95% CI: 1.15-2.85]) conferred higher odds of PCE. There were 2298 total readmissions, of which 46 (2%) had PCE, with no difference in median readmission rate for patients diagnosed with PCE at index hospitalization (median 0 [IQR: 0-1] vs 0 [IQR: 0-0], P = .208). Conclusions: PCE occurred after 6.1% of ASO and was associated with pleural effusions and mechanical circulatory support. PCE is associated with morbidity and prolonged length of stay; however, there was no association with in-hospital mortality or readmissions.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review

Mikulski

Well

Subramanian

et al. 2023

World J Pediatr Congenit Heart Surg

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“… 1 There is a dearth of literature focused exclusively on the risk factors of this metric of postoperative morbidity in children. 1 , 2 , 4 As we continue to improve on the outcomes of congenital cardiac surgery it is prudent to study this unwanted complication in more detail in the current era.…”

mentioning

confidence: 99%

“…In this issue of the Journal , Noma and colleagues 2 report on their analysis of the Japan Congenital Cardiovascular Surgery Database to assess the incidence and predictive factors of readmission or the need for drainage of PE after congenital heart surgery. We congratulate the authors for their in-depth analysis of the database that has added to our understanding of this postoperative complication.…”

mentioning

confidence: 99%