HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hartzell V. Schaff Joseph A. Dearani Rakesh M. Suri Soon J. Park Thomas A. Orszulak Thoralf M. Sundt, III Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ashikhmina, E. A. Articles by Sundt, T. M. Search for Related Content PubMed PubMed Citation Articles by Ashikhmina, E. A. Articles by Sundt, T. M., III Related Collections Pericardium

---

Original Articles: Adult Cardiac

Pericardial Effusion After Cardiac Surgery: Risk Factors, Patient Profiles, and Contemporary Management

^a Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
^b Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota

Accepted for publication September 14, 2009.

^_* Address correspondence to Dr Schaff, Division of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Email: schaff{at}mayo.edu).

Background: We aimed to review recent experience at our institution in the diagnosis and treatment of pericardial effusion after cardiac surgery and to identify risk factors for its development.

Methods: We searched our clinical database for patients 18 years or older who had cardiac surgery with cardiopulmonary bypass from 1993 through 2005. For patients with pericardial effusion (study group), medical records were reviewed to evaluate its manifestations and management. To identify risk factors for effusion, study patients were compared with patients without effusions. A second analysis compared the study group with a cohort without effusions who had routine postoperative echocardiographic examination.

Results: Of 21,416 patients identified, 327 (1.5%) had pericardial effusion (study group), 280 (86%) of whom had nonspecific symptoms. Clinical features of tamponade were documented in 138 patients (42%). Effusions were evacuated by echocardiography-guided pericardiocentesis (n = 169, 52%) or surgical drainage (n = 75, 23%). Effusion resolved after left thoracocentesis for pleural effusion in 3 patients (1%); 67 patients (20%) were treated conservatively. In 13 cases (4%), recurrent effusion required drainage after initial pericardiocentesis. Independent risk factors for effusion were larger body surface area, pulmonary thromboembolism, hypertension, immunosuppression, renal failure, urgency of operation, cardiac operation other than coronary artery bypass grafting, and prolonged cardiopulmonary bypass. Previous cardiac operations were associated with lower risk of effusion.

Conclusions: In our study, pericardial effusion occurred in 1.5% of patients, and symptoms were nonspecific. Several factors, mainly related to preoperative characteristics and type of operation, predispose patients to effusion. Echocardiography-guided pericardiocentesis is effective and safe in these patients.

This article has been cited by other articles:

				G. M. Frohlich, P. Keller, F. Schmid, M. Wolfrum, M. Osranek, C. Falk, G. Noll, F. Enseleit, M. Reinthaler, P. Meier, et al. Haemodynamically irrelevant pericardial effusion is associated with increased mortality in patients with chronic heart failure Eur. Heart J., May 1, 2013; 34(19): 1414 - 1423. [Abstract] [Full Text] [PDF]

				J. H. Karimov, A. M. Gillinov, L. Schenck, M. Cook, D. Kosty Sweeney, E. M. Boyle, and K. Fukamachi Incidence of chest tube clogging after cardiac surgery: a single-centre prospective observational study Eur J Cardiothorac Surg, March 21, 2013; (2013) ezt140v1. [Abstract] [Full Text] [PDF]

				E. Catena, C. Addamiano, E. Bertoli, S. Maggiolini, A. Farina, and F. Achilli Pericardiocentesis From Back Under Echographic Guidance: An Approach for Posterior Pericardial Effusions Circulation, December 13, 2011; 124(24): e835 - e836. [Full Text] [PDF]

				G. Pompilio, S. Filippini, M. Agrifoglio, E. Merati, G. Lauri, S. Salis, F. Alamanni, and A. Parolari Determinants of pericardial drainage for cardiac tamponade following cardiac surgery Eur J Cardiothorac Surg, May 1, 2011; 39(5): e107 - e113. [Abstract] [Full Text] [PDF]