Pericardial effusion after congenital heart surgery

© 2022 The Author(s)..

Objective: Pericardial effusion after cardiac surgery remains an important cause of morbidity and mortality. We describe the risk factors of pericardial effusion after congenital heart surgery through analyzing data from a nationwide, multi-institutional registry.

Methods: The Japan Congenital Cardiovascular Surgery Database, which reflects routine clinical care in Japan, was used for this retrospective cohort study. Multivariable regression analysis was done after univariable comparison of patients with pericardial effusion and no pericardial effusion.

Results: The study enrolled 64,777 patients registered with the Japan Congenital Cardiovascular Surgery Database between 2008 and 2016; 909 of these had postoperative pericardial effusion (1.4%) and were analyzed along with 63,868 patients without pericardial effusion. Univariable analysis found no difference between the groups in terms of gender, early delivery, or preoperative mechanical ventilatory support. In the pericardial effusion group, cardiopulmonary bypass use was lower (58.4% vs 62.1%), whereas the cardiopulmonary bypass time (176.9 vs 139.9 minutes) and aortic crossclamp time (75.1 vs 62.2 minutes) were longer, and 30-day mortality was higher (4.1% vs 2.2%). Multivariable analysis identified trisomy 21 (odds ratio, 1.54), 22q.11 deletion (odds ratio, 2.17), first-time cardiac surgery (odds ratio, 2.01), and blood transfusion (odds ratio, 1.43) as independent risk factors of postoperative pericardial effusion. In contrast, neonates, infants, ventricular septal defect, atrial septal defect, tetralogy of Fallot repair, and arterial switch operation were correlated with a low risk of pericardial effusion development.

Conclusions: The incidence of postoperative pericardial effusion in congenital cardiac surgery was 1.4%. Trisomy 21, 22q.11 deletion, first-time cardiac surgery, and blood transfusion were identified as the principal factors predicting the need for pericardial effusion drainage.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:9

Enthalten in:

JTCVS open - 9(2022) vom: 15. März, Seite 237-243

Sprache:

Englisch

Beteiligte Personen:

Noma, Mio [VerfasserIn]
Hirata, Yasutaka [VerfasserIn]
Hirahara, Norimichi [VerfasserIn]
Suzuki, Takaaki [VerfasserIn]
Miyata, Hiroaki [VerfasserIn]
Hiramatsu, Yuji [VerfasserIn]
Yoshimura, Yukihiro [VerfasserIn]
Takamoto, Shinichi [VerfasserIn]

Links:

Volltext

Themen:

22q.11 deletion
ASD, atrial septal defect
Blood transfusion
CPB, cardiopulmonary bypass
Congenital heart surgery
First-time surgery
JCCVSD, Japan Congenital Cardiovascular Surgery Database
Journal Article
OR, odds ratio
PA, pulmonary artery
PE, pericardial effusion
PPS, postpericardiotomy syndrome
Postoperative pericardial effusion
Postpericardiotomy syndrome
TOF, tetralogy of Fallot
Trisomy 21
VSD, ventricular septal defect

Anmerkungen:

Date Revised 26.08.2022

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.xjon.2022.01.001

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM345218841