Authors

• Krešimir Gabaldo — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-0116-5929
• Irzal Hadžibegović — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-3768-9134
• Domagoj Mišković — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0003-4600-0498
• Željko Sutlić — University Hospital Dubrava, Zagreb, Croatia — ORCID: 0000-0001-6926-9436
• Đeiti Prvulović — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-8041-1197
• Božo Vujeva — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0003-0490-3832
• Marijana Knežević — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
• Praveček — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-8727-7357
• Katica Cvitkušić — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
• Lukenda — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0001-6188-0708

Abstract

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.

Keywords

pericarditis, pleural effusion, complications of heart surgery

DOI

Literature

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