Predictors of pericardial effusion after orthotopic heart transplantation

Abstract

Postoperative pericardial effusions develop in approximately 20% of patients undergoing orthotopic cardiac transplantation. On the basis of the risk factors identified in this study, prevention may prove difficult, although avoidance of the intraoperative use of aminocaproic acid may be helpful.

Wound Healing Complications with De Novo Sirolimus Versus Mycophenolate Mofetil-Based Regimen in Cardiac Transplant Recipients

“…It cannot be explained on the same principle as the formation of lymphoceles post-renal transplantation, which occurs in the non-absorptive retroperitoneal space. After cardiac transplant surgeries, an incidence of 21% moderate to large pericardial effusion (18) and 6% pleural effusion (19) have been reported in the absence of immunosuppression with sirolimus. The pericardial effusion may be explained by post-operative bleeding, however, an imbalance in the production and absorption of the secretion by the epithelial lining of the pleural…”

Everolimus immunosuppression in de novo heart transplant recipients: What does the evidence tell us now?

“…Pericardial effusion is a frequent occurrence after heart transplantation, with moderately to large effusions reported in approximately a fifth of recipients (73,(75)(76)(77). Mortality and hospital stay are unaffected (75)(76)(77), although one study suggested an association between pericardial effusions and acute rejection (78).…”

“…Mortality and hospital stay are unaffected (75)(76)(77), although one study suggested an association between pericardial effusions and acute rejection (78).…”

Comparative study of granisetron and ondansetron alone and their combination with dexamethasone, for prevention of PONV in middle ear surgery

“…Subsequent clot lysis may encourage fluid inspissation, leading to an effusion. However, it is noteworthy that the amount of mediastinal chest drainage, duration of chest tube drainage, and the quantities of blood products administered after transplantation were not found to correlate with the development of pericardial effusions (12). So, the underlying basis for CP in the posttransplant setting is most likely the accumulation of blood products within the pericardial sac with subsequent deposition and healing of the pericardial surface.…”

“…Antifibrinolytic agents, such as aminocaproic acid, can be used in the perioperative setting to reduce postoperative bleeding. This agent was found to be associated with a dramatically increased incidence of postoperative pericardial effusion and may contribute to retention of clots within the pericardial sac (10,12). Subsequent clot lysis may encourage fluid inspissation, leading to an effusion.…”