Pericardial effusion after cardiac surgery: Incidence, relation to the type of surgery, antithrombotic therapy, and early coronary bypass graft patency

Abstract

To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combination of aspirin and dipyridamole and 50 receiving warfarin). PE was found during either procedure in 77% of patients and was marked in 29%. Symptoms of postpericardiotomy syndrome ( p < 0.05), pericardial friction rub ( p < 0.01), atrial arrhythmias ( p < 0.05), cardiac enlargement ( p < 0.01), and pleural effusion ( p < 0.05) were detected more frequently in patients with PE than in those without PE. PE was not related to the type of antithrombotic therapy, the rate of coronary bypass graft occlusion, or the type of cardiac surgery. However, the use of the left internal mammary artery as a coronary bypass graft was associated with a slightly higher incidence of PE ( p < 0.05). One patient (0.7%) required surgical drainage of PE. It was concluded that PE is a common and benign finding after cardiac surgery and usually disappears without specific therapy.