Postpericardiotomy syndrome in aortic valve surgery – incidence, diagnosis and treatment

    Authors

    Keywords

    pericarditis, pleural effusion, complications of heart surgery

    DOI

    https://doi.org/10.15836/ccar2016.626

    Full Text

    Postpericardial injury syndrome (PPIS) is a clinical syndrome that occurs in autoimmune inflammatory reaction within the pericardium and pleura, and manifests with the pericardial and pleural effusion. It occurs in patients who undergo cardiac surgery involving the opening of the pericardium and is among the most common complications of cardiac surgery in the late postoperative time. The incidence of the disease ranges from 2-30%, averaging about 10%. ( 1 - 3 ) Retrospective analysis of the PPIS register at the General Hospital “Dr. J. Benčević” Slavonski Brod in the period from March 1, 2009 to October 1, 2015 shows incidence of the PPIS overall, regardless of the type of procedure of 10.1%, while the incidence of PPIS in patients who underwent aortic valve surgery was 26%. We recommend routine screening of patients 2-4 weeks after the surgery by simple diagnostic criteria. For the diagnosis elevated CRP and fever have strong predictive value and in the presence of pleural/ pericardial effusion sufficient criteria for the diagnosis of disease. The treatment is carried out by using NSAIDs, colchicine or corticosteroids, with the achievement of remission in more than 95% of patients. The prophylactic use of colchicine according to COPPS study reduces the incidence of PPS. While there are no clear recommendations for prophylaxis according to our research, the identification of patients at high risk based on the type of operation, age and other clinical parameters support the hypothesis about the usefulness of prophylaxis.

    Cardiologia Croatica
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    Postpericardiotomy syndrome in aortic valve surgery – incidence, diagnosis and treatment

    Extended Abstract
    Issue12
    Published
    Pages626
    PDF via DOIhttps://doi.org/10.15836/ccar2016.626
    pericarditis
    pleural effusion
    complications of heart surgery

    Authors

    Krešimir Gabaldo*ORCIDCroatia
    Irzal HadžibegovićORCIDCroatia
    Domagoj MiškovićORCIDCroatia
    Željko SutlićORCIDCroatia
    Đeiti PrvulovićORCIDCroatia
    Božo VujevaORCIDCroatia
    Marijana KneževićCroatia
    PravečekORCIDCroatia
    Katica CvitkušićCroatia
    LukendaORCIDCroatia

    Full Text

    Postpericardial injury syndrome (PPIS) is a clinical syndrome that occurs in autoimmune inflammatory reaction within the pericardium and pleura, and manifests with the pericardial and pleural effusion. It occurs in patients who undergo cardiac surgery involving the opening of the pericardium and is among the most common complications of cardiac surgery in the late postoperative time. The incidence of the disease ranges from 2-30%, averaging about 10%. ( 1 - 3 ) Retrospective analysis of the PPIS register at the General Hospital “Dr. J. Benčević” Slavonski Brod in the period from March 1, 2009 to October 1, 2015 shows incidence of the PPIS overall, regardless of the type of procedure of 10.1%, while the incidence of PPIS in patients who underwent aortic valve surgery was 26%. We recommend routine screening of patients 2-4 weeks after the surgery by simple diagnostic criteria. For the diagnosis elevated CRP and fever have strong predictive value and in the presence of pleural/ pericardial effusion sufficient criteria for the diagnosis of disease. The treatment is carried out by using NSAIDs, colchicine or corticosteroids, with the achievement of remission in more than 95% of patients. The prophylactic use of colchicine according to COPPS study reduces the incidence of PPS. While there are no clear recommendations for prophylaxis according to our research, the identification of patients at high risk based on the type of operation, age and other clinical parameters support the hypothesis about the usefulness of prophylaxis.