Abstract
This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage. The median time of pericardial drainage after surgery was 17 (interquartile range, IQR, 13–30) days. Infective endocarditis, mechanical valve replacement of aortic or mitral valve, and any amount of pericardial effusion (PE) on the first postoperative TTE were related to the occurrence of cardiac tamponade (all p<0.05). After multivariate adjustment, occurrence of cardiac tamponade was associated with any amount of PE on the first postoperative TTE (hazard ratio, HR, 14.00, p<0.001) and mechanical valve replacement (HR 2.69, p = 0.025). The mean hospital days in patients with cardiac tamponade was higher than those without (34.9 vs. 13.5, p = 0.031). After pericardial drainage, there was no echocardiographic recurrence of significant PE during a median of 34.8 (IQR 14.9–43.7) months after surgery. Cardiac tamponade after heart valve surgery is not uncommon. Patients with any amount of PE at the first postoperative TTE or mechanical valve replacement should receive higher attention with regard to the occurrence of cardiac tamponade. Although it prolongs hospital stay, cardiac tamponade exhibits a benign clinical course without recurrence after timely intervention.
Highlights
Pericardial effusion (PE) after cardiac surgery is a commonly encountered finding, even in patients without evidence of postoperative pericardial hemorrhage
A few studies demonstrated that postoperative PE or consequent constrictive physiology were prevalent in patients undergoing coronary artery bypass grafting (CABG) [6,7]
There were no significant differences in demographic characteristics, proportion of underlying valve function, or Demographic characteristics Age, years ± SD Male gender, n (%) Body mass index, kg/m2 ± SD Prior history of valve operation, n (%)
Summary
Pericardial effusion (PE) after cardiac surgery is a commonly encountered finding, even in patients without evidence of postoperative pericardial hemorrhage. Cardiac Tamponade After Heart Valve Surgery an inflammatory process of the pericardium, called post-pericardiotomy syndrome (PPS) [1]. It mostly exhibits a benign course without clinically serious complications, it is able to progress to potentially lethal cardiac tamponade which is associated with increased morbidity and mortality [2,3,4,5]. A few studies demonstrated that postoperative PE or consequent constrictive physiology were prevalent in patients undergoing coronary artery bypass grafting (CABG) [6,7]. There would be considerable variations in the incidence of PE and the consequent clinical course according to the types of surgery, underlying diseases, or the use of anticoagulants in patients undergoing heart valve surgery. We tried to define clinical or echocardiographic predictors of cardiac tamponade occurrence following heart valve surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
