Incidence and factors associated with pericardial effusion after cardiac valve surgery

Autores

  • Eduardo Ferreira Martins Universidade Federal do Rio Grande do Sul, Porto Alegre - RS, Brasil
  • Adriano Heemann Pereira Neto Universidade Federal do Rio Grande do Sul, Porto Alegre - RS, Brasil
  • Lucas Danielli Universidade Federal do Rio Grande do Sul, Porto Alegre - RS, Brasil
  • Lisandra Almeida Nunes Universidade Federal do Rio Grande do Sul, Porto Alegre - RS, Brasil
  • Maria Vitória França do Amaral Serviço de Cardiologia. Hospital de Clínicas de Porto Alegre, Porto Alegre - RS, Brasil
  • Paulo Kalil Serviço de Cardiologia. Hospital de Clínicas de Porto Alegre, Porto Alegre - RS, Brasil
  • Orlando Wender Universidade Federal do Rio Grande do Sul, Porto Alegre - RS, Brasil
  • Murilo Foppa Serviço de Cardiologia. Hospital de Clínicas de Porto Alegre, Porto Alegre - RS, Brasil
  • Ângela Barreto Santiago Santos Serviço de Cardiologia. Hospital de Clínicas de Porto Alegre, Porto Alegre - RS, Brasil

Palavras-chave:

Adult, pericardium, postoperative care

Resumo

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.

Keywords: Adult; pericardium; postoperative care

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Publicado

2017-04-20

Como Citar

1.
Martins EF, Pereira Neto AH, Danielli L, Nunes LA, do Amaral MVF, Kalil P, Wender O, Foppa M, Santos Ângela BS. Incidence and factors associated with pericardial effusion after cardiac valve surgery. Clin Biomed Res [Internet]. 20º de abril de 2017 [citado 30º de janeiro de 2023];37(1). Disponível em: https://seer.ufrgs.br/index.php/hcpa/article/view/69289

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