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Incidence and factors associated with pericardial effusion after cardiac valve surgery
Martins, Eduardo Ferreira; Pereira Neto, Adriano Heemann; Danielli, Lucas; Nunes, Lisandra Almeida; Amaral, Maria Vitória França do; Kalil, Paulo; Wender, Orlando; Foppa, Murilo; Santos, Ângela Barreto Santiago.
  • Martins, Eduardo Ferreira; Universidade Federal do Rio Grande do Sul. Porto Alegre. BR
  • Pereira Neto, Adriano Heemann; Universidade Federal do Rio Grande do Sul. Porto Alegre. BR
  • Danielli, Lucas; Universidade Federal do Rio Grande do Sul. Porto Alegre. BR
  • Nunes, Lisandra Almeida; Universidade Federal do Rio Grande do Sul. Porto Alegre. BR
  • Amaral, Maria Vitória França do; Hospital de Clínicas de Porto Alegre. Cardiology Division. Porto Alegre. BR
  • Kalil, Paulo; Hospital de Clínicas de Porto Alegre. Cardiology Division. Porto Alegre. BR
  • Wender, Orlando; Hospital de Clínicas de Porto Alegre. Cardiology Division. Porto Alegre. BR
  • Foppa, Murilo; Hospital de Clínicas de Porto Alegre. Cardiology Division. Porto Alegre. BR
  • Santos, Ângela Barreto Santiago; Hospital de Clínicas de Porto Alegre. Porto Alegre. BR
Clin. biomed. res ; 37(1): 18-24, 2017. ilus, tab
Article in English | LILACS | ID: biblio-833270
ABSTRACT

Introduction:

Pericardial effusion (PE) is a postoperative complication of cardiac valve surgery, related to early hospital readmissions and death. We aimed to describe its incidence and to identify predictive factors of moderate-to-severe PE in a contemporary cohort.

Methods:

We retrospectively reviewed medical records of all consecutive patients submitted to cardiac valve surgery in a tertiary teaching hospital from January 2012 to July 2014, where echocardiography was routinely performed before patient discharge. Moderate-to-severe PE was defined as ≥ 10 mm of thickness, or signs of cardiac tamponade on echocardiography. Additional clinical and perioperative data were extracted from medical records using a standardized protocol.

Results:

Of 353 patients, 335 underwent a predischarge echocardiography. From these, 27 patients (8%; mean age 62 years; standard deviation 12 years; 70% male) had moderate-to-severe PE. These patients had a higher prevalence of previous stroke (22% vs. 8%; p = 0.009) and oral anticoagulation (international normalized ratio > 2) prior to the surgery (11 vs. 2%; P = 0.002). In patients with moderate-to-severe PE, surgeries had longer ischemia (p < 0.001) and cardiopulmonary bypass (p < 0.001) times, and the prevalence of postoperative atrial fibrillation was higher (56% vs. 32%; p = 0.011) than in patients with absent or small PE. Hospital mortality was also higher (15% vs. 3%; p = 0.002) in patients with moderate-to-severe PE.

Conclusions:

Eight percent of patients submitted to cardiac valve surgery developed moderate-to-severe PE. Moreover, PE was associated with pre- and post-surgery conditions likely related to the coagulation state, though a cause-effect relationship could not be inferred. Noteworthy, this condition was associated with higher in-hospital morbidity and mortality(AU)
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pericardial Effusion / Cardiac Surgical Procedures Type of study: Etiology study / Practice guideline / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Clin. biomed. res Journal subject: Medicine Year: 2017 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital de Clínicas de Porto Alegre/BR / Universidade Federal do Rio Grande do Sul/BR

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Full text: Available Index: LILACS (Americas) Main subject: Pericardial Effusion / Cardiac Surgical Procedures Type of study: Etiology study / Practice guideline / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Clin. biomed. res Journal subject: Medicine Year: 2017 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital de Clínicas de Porto Alegre/BR / Universidade Federal do Rio Grande do Sul/BR