Postpericardiotomy syndrome: no evidence for a viral etiology

Abstract

Our study has provided no evidence to support a viral etiology for the postpericardiotomy syndrome.

Soluble endothelial adhesion molecules during paediatric cardiovascular surgery with or without cardiopulmonary bypass

“…None of the patients with pericardial effusion fulfilled the criterions of postpericardiotomy syndrome. 29 The later intrahospital and follow-up outcome was good for all patients.…”

“…27,28 The changes of circulating soluble adhesion molecules have been documented in adults, where the concentration of soluble E-selectin has been shown to decrease during cardiovascular surgery with cardiopulmonary bypass. 27 In children, different changes of soluble adhesion molecules during surgery with cardiopulmonary bypass have been documented, 2,29 but no study compared the endothelial response to cardiac surgery with and without cardiopulmonary bypass. The aim of the present study, therefore, was to investigate and compare the sequels of soluble endothelial adhesion molecules in children undergoing cardiovascular surgery with and without cardiopulmonary bypass.…”

Methotrexate in recurrent postpericardiotomy syndrome

“…A fourfold rise in viral antibody titer was found in over two-thirds of those with clinical evidence of the syndrome, compared with only one-twentieth in those without clinical evidence of pericardial involvement. A recent study using serology, polymerase chain reaction, and viral cultures, 5 however, has failed to confirm a viral etiology. Another study 6 demonstrated an association between the postpericardiotomy syndrome and circulating anti-cardiac antibodies, with the formation of immune complexes during exposure of the cardiac antigen at surgery.…”

Postpericardiotomy syndrome after cardiac surgery

“…In the major PPS studies during the last decades, the reported incidences have been the following: 10-28% in children [32][33][34][35][36] and 9-21% in adults [8,12,13,37,38] with a median of 16% in adult patients [14]. In the recent Colchicine for Prevention of Postpericardiotomy Syndrome and Postoperative Atrial Fibrillation (COPPS-2) trial [7], the incidence in adult patients was as high as 29% in elderly patients, although the time limit of fever was abandoned resulting in a markedly higher occurrence during the first postoperative days compared to the Colchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS) trial [8].…”

“…Patient-dependent factors Numerous previous studies have evaluated the risk factors for PPS to both clarify the cause of the syndrome and to identify the patients with the highest risk of developing the disease. One of the few risk factors several studies have agreed upon is female sex [5,34,70,71]. It has been previously suggested that the female predominance might reflect the different predisposition to autoimmune pathogenesis, as it is known that women are more susceptible to a variety of autoimmune diseases [72] possibly due to the effects of sex hormones on the immune system, genetic factors, and sex-specific behaviours and exposures [73].…”