1
|
Feng J, Appareddy NS, Gibran Y, Garza A, Luevano J, Garcia G. Rare Presentation of Postpericardiotomy Syndrome After Left Atrial Myxoma Removal. J Investig Med High Impact Case Rep 2023; 11:23247096231217858. [PMID: 38105244 PMCID: PMC10729611 DOI: 10.1177/23247096231217858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/12/2023] [Accepted: 11/12/2023] [Indexed: 12/19/2023] Open
Abstract
Postpericardiotomy syndrome (PPS) is a known complication of cardiac valve surgery, but it has not been commonly reported as a postoperative complication of cardiac myxoma removal. A 78-year-old female with hypertension and atrial fibrillation presenting with angina was found to have a large left atrial myxoma (7.5 cm × 4.4 cm). The myxoma was resected; however, 1-week postoperation hemoglobin and blood pressure decreased with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Limited transthoracic echocardiogram (TTE) showed moderate pericardial effusion, confirming the diagnosis of PPS. This case highlights the importance of monitoring patients postremoval of myxoma for symptoms of PPS.
Collapse
Affiliation(s)
- Jessy Feng
- University of Texas Rio Grande Valley School of Medicine, Edinburg, USA
| | | | - Yaman Gibran
- University of Texas Rio Grande Valley School of Medicine, Edinburg, USA
| | - Aryana Garza
- University of Texas Rio Grande Valley School of Medicine, Edinburg, USA
| | | | | |
Collapse
|
2
|
Deftereos SG, Beerkens FJ, Shah B, Giannopoulos G, Vrachatis DA, Giotaki SG, Siasos G, Nicolas J, Arnott C, Patel S, Parsons M, Tardif JC, Kovacic JC, Dangas GD. Colchicine in Cardiovascular Disease: In-Depth Review. Circulation 2022; 145:61-78. [PMID: 34965168 PMCID: PMC8726640 DOI: 10.1161/circulationaha.121.056171] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Inflammation plays a prominent role in the development of atherosclerosis and other cardiovascular diseases, and anti-inflammatory agents may improve cardiovascular outcomes. For years, colchicine has been used as a safe and well-tolerated agent in diseases such as gout and familial Mediterranean fever. The widely available therapeutic has several anti-inflammatory effects, however, that have proven effective in a broad spectrum of cardiovascular diseases as well. It is considered standard-of-care therapy for pericarditis, and several clinical trials have evaluated its role in postoperative and postablation atrial fibrillation, postpericardiotomy syndrome, coronary artery disease, percutaneous coronary interventions, and cerebrovascular disease. We aim to summarize colchicine's pharmacodynamics and the mechanism behind its anti-inflammatory effect, outline thus far accumulated evidence on treatment with colchicine in cardiovascular disease, and present ongoing randomized clinical trials. We also emphasize real-world clinical implications that should be considered on the basis of the merits and limitations of completed trials. Altogether, colchicine's simplicity, low cost, and effectiveness may provide an important addition to other standard cardiovascular therapies. Ongoing studies will address complementary questions pertaining to the use of low-dose colchicine for the treatment of cardiovascular disease.
Collapse
Affiliation(s)
| | - Frans J. Beerkens
- Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Binita Shah
- VA New York Harbor Healthcare System, New York University School of Medicine, New York, NY, USA
| | | | | | - Sotiria G. Giotaki
- Medical School, National Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Siasos
- Medical School, National Kapodistrian University of Athens, Athens, Greece
| | - Johny Nicolas
- Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Clare Arnott
- The George Institute for Global Health, & Faculty of Medicine, University of New South Wales, Sydney, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, & Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sanjay Patel
- Department of Cardiology, Royal Prince Alfred Hospital, & Sydney Medical School, University of Sydney, Sydney, Australia
| | - Mark Parsons
- Department of Neurology, Liverpool Hospital & Ingham Institute for Applied Medical Research at South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia
| | - Jean-Claude Tardif
- Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Jason C. Kovacic
- Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Victor Chang Cardiac Research Institute, Darlinghurst, Australia; and St Vincent’s Clinical School, University of New South Wales, Darlinghurst, Australia
| | - George D. Dangas
- Medical School, National Kapodistrian University of Athens, Athens, Greece.,Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
3
|
Adamczyk M, Wasilewski J, Niedziela JT, Zembala MO, Gąsior M. Baseline characteristics, management and long-term outcomes of different etiologies of cardiac tamponade evaluated in a cohort of 340 patients. Kardiochir Torakochirurgia Pol 2021; 18:216-220. [PMID: 35079262 PMCID: PMC8768860 DOI: 10.5114/kitp.2021.112187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/19/2021] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Studies on the etiology of cardiac tamponade (CT) are scarce or lacking follow-up, and usually include small or highly selected groups of patients. AIM To evaluate the various etiologies and outcomes of CT in a cohort of patients treated in a tertiary care hospital encompassing cardiology, cardiac surgery and intensive care units. MATERIAL AND METHODS We retrospectively analyzed all adult patients hospitalized in the Silesian Centre for Heart Diseases in Zabrze (Poland) between January 2008 and December 2018, who required therapeutic pericardiocentesis or pericardiotomy due to CT. All various etiologies of CT were presented and assigned to the main etiology groups. For each group basic characteristics, in-hospital management, in-hospital and up to 2-year mortality were analyzed. RESULT Among 340 patients with CT, 56% were men. The leading etiology groups included patients after invasive cardiac procedures, patients following postpericardiotomy (PCT) syndrome and the patients with neoplasm. Patients with end stage renal failure, PCT and iatrogenic CTs were the most disease burdened groups. The highest need for advanced therapy and in-hospital mortality were observed for the acute myocardial infarction group, in contrast to PCT. CONCLUSIONS Within our cohort of patients, the invasive cardiac procedures overtake neoplastic causation of cardiac tamponade. The worst in-hospital prognosis was noted for CT following acute myocardial infarction and both iatrogenic invasive cardiac and cardiac surgery procedures. The highest long-term mortality was recorded for patients with end stage renal failure and the neoplastic group.
Collapse
Affiliation(s)
- Mária Adamczyk
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Jarosław Wasilewski
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Jacek T. Niedziela
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Michał O. Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantation, Silesian Center for Heart Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Mariusz Gąsior
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| |
Collapse
|
4
|
Lee YJ, Mubasher M, Zainal A, Syed T, Mohamed MFH, Ferrantino M, Hoefen R. Pacemaker-Associated Post-cardiac Injury Syndrome Presenting with Tamponade and Recurrent Pleural Effusion. Clin Med Insights Case Rep 2020; 13:1179547620965559. [PMID: 33192113 PMCID: PMC7607781 DOI: 10.1177/1179547620965559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/20/2020] [Indexed: 11/24/2022]
Abstract
Post-cardiac injury syndrome (PCIS) is presumed to be an immune-mediated process. It affects the pericardium and, to a lesser extent, the epicardium, myocardium, and pleura. It has been rarely reported following pacemaker insertion with an estimated incidence of 1% to 2%. We present the case of a 62-year-old female who developed PCIS 8 weeks following pacemaker insertion. She presented with impending cardiac tamponade requiring pericardiocentesis; recurrent pleural effusions subsequently complicated her condition. The pleural effusion recurred despite trials of steroids, eventually requiring talc pleurodesis. This case highlights the need to consider PCIS as a possible etiology of recurrent pleural effusion following pacemaker insertion.
Collapse
Affiliation(s)
- Young Ju Lee
- Unity Hospital, Rochester Regional Health, Rochester, New York, USA
| | - Mahmood Mubasher
- Unity Hospital, Rochester Regional Health, Rochester, New York, USA
| | - Abir Zainal
- Unity Hospital, Rochester Regional Health, Rochester, New York, USA
| | - Tausif Syed
- Unity Hospital, Rochester Regional Health, Rochester, New York, USA
| | | | | | - Ryan Hoefen
- Unity Hospital, Rochester Regional Health, Rochester, New York, USA
| |
Collapse
|
5
|
Bernhardt L, Sogomonian R, Sood A, Hammons L, Haftevani EA, Gowda RM. Ozaki procedure complicated by postpericardiotomy syndrome and cardiac tamponade. Future Cardiol 2020; 17:301-307. [PMID: 32945199 DOI: 10.2217/fca-2020-0099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aortic valve replacement has long been the standard of care for many aortic valve diseases. Neo sinus reconstruction and aortic valve reconstruction with native pericardium, known as the Ozaki procedure, is a relatively new technique with early studies showing good mid-term durability and hemodynamics without the need for life-long anticoagulation. We present the case of a 56-year-old male presenting with aortic valve endocarditis and severe aortic insufficiency who underwent successful aortic valve reconstruction via the Ozaki procedure complicated by postpericardiotomy syndrome and cardiac tamponade. Although the Ozaki procedure is a promising alternative to conventional aortic valve replacement, further study is needed to determine long-term re-operation rates, stability and mortality.
Collapse
Affiliation(s)
- Logan Bernhardt
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, NY, 10003, USA
| | - Robert Sogomonian
- Department of Cardiovascular Diseases, Mount Sinai Heart at Mount Sinai Beth Israel, NY, 10003, USA
| | - Abhinav Sood
- Department of Cardiovascular Diseases, Mount Sinai Heart at Mount Sinai Beth Israel, NY, 10003, USA
| | - Lindsay Hammons
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, NY, 10003, USA
| | | | - Ramesh M Gowda
- Department of Cardiovascular Diseases, Mount Sinai Heart at Mount Sinai Beth Israel, NY, 10003, USA
| |
Collapse
|
6
|
Lehto J, Kiviniemi T, Gunn J, Airaksinen J, Rautava P, Kytö V. Occurrence of Postpericardiotomy Syndrome: Association With Operation Type and Postoperative Mortality After Open-Heart Operations. J Am Heart Assoc 2019; 7:e010269. [PMID: 30571490 PMCID: PMC6404434 DOI: 10.1161/jaha.118.010269] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Postpericardiotomy syndrome (PPS) is a common complication after cardiac surgery. However, large‐scale epidemiological studies about the effect of procedure type on the occurrence of PPS and mortality of patients with PPS have not yet been performed. Methods and Results We studied the association of PPS occurrence with operation type and postoperative mortality in a nationwide follow‐up analysis of 28 761 consecutive patients entering coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, or ascending aortic surgery. Only PPS episodes severe enough to result in hospital admission or to contribute as a cause of death were included. Data were collected from mandatory Finnish national registries between 2005 and 2014. Of all the patients included, 493 developed PPS during the study period. The occurrence of PPS was significantly higher after aortic valve replacement (hazard ratio, 1.97; 95% confidence interval, 1.58–2.46; P<0.001), mitral valve replacement (hazard ratio, 1.62; 95% confidence interval, 1.22–2.15; P<0.001), and aortic surgery (hazard ratio, 3.06; 95% confidence interval, 2.24–4.16; P<0.001), when compared with coronary artery bypass grafting in both univariable and multivariable analyses. The occurrence of PPS decreased significantly with aging (P<0.001). The occurrence of PPS was associated with an increased risk of mortality within the first year after the surgery (adjusted hazard ratio, 1.78; 95% confidence interval, 1.12–2.81; P=0.014). Conclusions The occurrence of PPS was higher after aortic valve replacement, mitral valve replacement, and aortic surgery when compared with the coronary artery bypass grafting procedure. Aging decreased the risk of PPS. The development of PPS was associated with higher mortality within the first year after cardiac or ascending aortic surgery. See Editorial by https://doi.org/10.1161/JAHA.118.011118.
Collapse
Affiliation(s)
- Joonas Lehto
- 1 Heart Center Turku University Hospital Turku Finland.,3 University of Turku Finland
| | - Tuomas Kiviniemi
- 1 Heart Center Turku University Hospital Turku Finland.,3 University of Turku Finland
| | - Jarmo Gunn
- 1 Heart Center Turku University Hospital Turku Finland.,3 University of Turku Finland
| | - Juhani Airaksinen
- 1 Heart Center Turku University Hospital Turku Finland.,3 University of Turku Finland
| | - Päivi Rautava
- 2 Clinical Research Center Turku University Hospital Turku Finland.,4 Department of Public Health University of Turku Finland
| | - Ville Kytö
- 1 Heart Center Turku University Hospital Turku Finland.,3 University of Turku Finland.,5 Research Center of Applied and Preventive Cardiovascular Medicine University of Turku Finland
| |
Collapse
|
7
|
Vnukov VV, Sidorov RV, Gvaldin DY, Milyutina NP, Ananyan AA, Pospelov DY, Plotnikov AA, Shlyk IF, Dоltmurzieva NS. [The role of myeloperoxidase, paraoxonase and nitric oxide system in blood and pericardial fluid in patients with IHD who underwent direct myocardial revascularization.]. Adv Gerontol 2019; 32:93-101. [PMID: 31228373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
76 patients with coronary artery disease who underwent aortocoronary bypass surgery were examined to study the role of paraoxonase, myeloperoxidase, arginase, asymmetric dimethylarginine and nitric oxide in the mechanisms of the pathogenesis of post-pericardiotomy syndrome (PPCS). Patients were divided into two groups: the 1st - patients with coronary artery disease, who did not have PPCS as a result of clinical studies; the 2nd- patients with ischemic heart disease (IHD who were diagnosed with PPCS. The results showed that the postoperative period after coronary artery bypass grafting is associated with inhibition of paraoxonase, activation of myeloperoxidase, increased activity of arginase, nitrite/nitrate level and asymmetric dimethylarginine, and may be accompanied by the development of endothelial dysfunction and increased systemic inflammatory response. In the present work, inverse correlation relationships between the arylesterase activity of paraoxonase and myeloperoxidase activity in plasma, as well as between the aryl esterase activity of paraoxonase in the blood plasma and the activity of arginase in erythrocytes of the patients of the two studied groups were established. tests were developed on basis of ratio of the enzymes activities to predict the development of post-pericardicotomy syndrome.
Collapse
Affiliation(s)
- V V Vnukov
- Southern Federal University, 105/42 B. Sadovaya str., Rostov-on-Don 344006, Russian Federation; e-mail:
| | - R V Sidorov
- Rostov State Medical University, 29 Nakhichevan lane, Rostov-on-Don 344022, Russian Federation
| | - D Y Gvaldin
- Southern Federal University, 105/42 B. Sadovaya str., Rostov-on-Don 344006, Russian Federation; e-mail:
| | - N P Milyutina
- Southern Federal University, 105/42 B. Sadovaya str., Rostov-on-Don 344006, Russian Federation; e-mail:
| | - A A Ananyan
- Southern Federal University, 105/42 B. Sadovaya str., Rostov-on-Don 344006, Russian Federation; e-mail:
| | - D Y Pospelov
- Rostov State Medical University, 29 Nakhichevan lane, Rostov-on-Don 344022, Russian Federation
| | - A A Plotnikov
- Southern Federal University, 105/42 B. Sadovaya str., Rostov-on-Don 344006, Russian Federation; e-mail:
| | - I F Shlyk
- Rostov State Medical University, 29 Nakhichevan lane, Rostov-on-Don 344022, Russian Federation
| | - N S Dоltmurzieva
- Rostov State Medical University, 29 Nakhichevan lane, Rostov-on-Don 344022, Russian Federation
| |
Collapse
|
8
|
van Osch D, Nathoe HM, Jacob KA, Doevendans PA, van Dijk D, Suyker WJ, Dieleman JM. Determinants of the postpericardiotomy syndrome: a systematic review. Eur J Clin Invest 2017; 47:456-467. [PMID: 28425090 DOI: 10.1111/eci.12764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 04/15/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Postpericardiotomy syndrome (PPS) is a common complication following cardiac surgery; however, the exact pathogenesis remains uncertain. Identifying risk factors of PPS might help to better understand the syndrome. The aim of this study was to provide an overview of existing literature around determinants of PPS in adult cardiac surgery patients. MATERIAL AND METHODS Two independent investigators performed a systematic search in MEDLINE, EMBASE and the Cochrane Central Register. The search aimed to identify studies published between January 1950 and December 2015, in which determinants of PPS were reported. RESULTS A total of 19 studies met the selection criteria. In these studies, 14 different definitions of PPS were used. The median incidence of PPS was 16%. After quality assessment, seven studies were considered eligible for this review. Lower preoperative interleukin-8 levels and higher postoperative complement conversion products were associated with a higher risk of PPS. Among other clinical factors, a lower age, transfusion of red blood cells and lower preoperative platelet and haemoglobin levels were associated with a higher risk of PPS. Colchicine use decreased the risk of PPS. CONCLUSION We found that both the inflammatory response and perioperative bleeding and coagulation may play a role in the development of PPS, suggesting a multifactorial aetiology of the syndrome. Due to a lack of a uniform definition of PPS in the past, study comparability was poor across the studies.
Collapse
Affiliation(s)
- Dirk van Osch
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hendrik M Nathoe
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Kirolos A Jacob
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Diederik van Dijk
- Department of Anesthesiology and Intensive Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Willem J Suyker
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan M Dieleman
- Department of Anesthesiology and Intensive Care, University Medical Center Utrecht, Utrecht, the Netherlands
| |
Collapse
|
9
|
Vnukov VV, Sidorov RV, Milutina NP, Ananyan AA, Gvaldin DY, Sagakyants AB, Shlyk IF, Talalaev EP. [Concentration of proinflammatory cytokines, peroxiredoxin-1 and glutathione peroxidase activity in the blood plasma of patients with coronary artery disease undergoing coronary artery bypass grafting]. Adv Gerontol 2017; 30:269-275. [PMID: 28575568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
76 patients with coronary heart disease (who had undergone coronary artery bypass grafting) were examined to investigate the role of pro-inflammatory cytokines and enzymes involved in redox regulation, in the mechanisms of development of systemic inflammatory response syndrome. Patients were divided into 2 groups: 1st - patients with coronary heart disease, who as a result of clinical trials has not been set postpericardiotomy syndrome; 2nd - patients with coronary heart disease who have been diagnosed postpericardiotomy syndrome. The blood plasma of both groups indicated intensification of production of interleukin-6, intrleukin-8, as well as - an imbalance in the peroxiredoxin-1 and glutathione peroxidase. These changes by patients with postpericardiotomy syndrome are observed at the earliest time and differed depth of expression. The results of this work confirm the high potential of the investigated indicators for prevention and monitoring postpericardiotomy syndrome development.
Collapse
Affiliation(s)
- V V Vnukov
- Southern Federal University, Rostov-on-Don, 344006, Russian Federation;
| | - R V Sidorov
- Rostov State Medical University, Rostov-on-Don, 344022, Russian Federation
| | - N P Milutina
- Southern Federal University, Rostov-on-Don, 344006, Russian Federation;
| | - A A Ananyan
- Southern Federal University, Rostov-on-Don, 344006, Russian Federation;
| | - D Yu Gvaldin
- Southern Federal University, Rostov-on-Don, 344006, Russian Federation;
| | - A B Sagakyants
- Southern Federal University, Rostov-on-Don, 344006, Russian Federation;
| | - I F Shlyk
- Rostov State Medical University, Rostov-on-Don, 344022, Russian Federation
| | - E P Talalaev
- Rostov State Medical University, Rostov-on-Don, 344022, Russian Federation
| |
Collapse
|
10
|
van Osch D, Dieleman JM, Bunge JJ, van Dijk D, Doevendans PA, Suyker WJ, Nathoe HM. Risk factors and prognosis of postpericardiotomy syndrome in patients undergoing valve surgery. J Thorac Cardiovasc Surg 2016; 153:878-885.e1. [PMID: 27919456 DOI: 10.1016/j.jtcvs.2016.10.075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 10/02/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The study aim was to investigate the long-term prognosis and risk factors of postpericardiotomy syndrome (PPS). METHODS We performed a single-center cohort study in 822 patients undergoing nonemergent valve surgery. Risk factors of PPS were evaluated using multivariable logistic regression analysis. We also compared the incidence of reoperation for tamponade at 1 year between patients with and without PPS. Main secondary outcomes were hospital stay and mortality. RESULTS Of the 822 patients, 119 (14.5%) developed PPS. A higher body mass index (odds ratio (OR) per point increase, 0.94; 95% confidence interval (CI), 0.89-0.99) was associated with a lower risk of PPS, whereas preoperative treatment for pulmonary disease without corticosteroids (OR, 2.55; 95% CI, 1.25-5.20) was associated with a higher risk of PPS. The incidence of reoperation for tamponade at 1 year in PPS versus no PPS was 20.9% versus 2.5% (OR, 15.49; 95% CI, 7.14-33.58). One-year mortality in PPS versus no PPS was 4.2% versus 5.5% (OR, 0.68; 95% CI, 0.22-2.08). Median hospital stay was 13 days (interquartile range, 9-18 days) versus 11 days (interquartile range, 8-15 days) (P = .001), respectively. CONCLUSIONS Despite longer hospital stays and more short-term reoperations for tamponade, patients with PPS had an excellent 1-year prognosis.
Collapse
Affiliation(s)
- Dirk van Osch
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Jan M Dieleman
- Department of Anesthesiology and Intensive Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen J Bunge
- Department of Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Diederik van Dijk
- Department of Anesthesiology and Intensive Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willem J Suyker
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hendrik M Nathoe
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | |
Collapse
|