Article ; Online: Echocardiographic Screening for Postoperative Pericardial Effusion in Children.
2021 Volume 42, Issue 7, Page(s) 1531–1538
Abstract: Pericardial effusion (PE) after cardiac surgery can be life threatening without timely detection, and the optimal screening method is unknown. We sought to evaluate the role of a surveillance echocardiogram on postoperative day 10 (± 2), determine the ... ...
| Abstract | Pericardial effusion (PE) after cardiac surgery can be life threatening without timely detection, and the optimal screening method is unknown. We sought to evaluate the role of a surveillance echocardiogram on postoperative day 10 (± 2), determine the incidence of postoperative PE, and identify risk factors. We conducted a retrospective cohort study including all pediatric patients who underwent open heart surgery at a single institution over a 7-month period. To identify risk factors for PE, medical records of patients with PE detected within 6 weeks after surgery (cases) were compared with patients without PE (controls). Of 203 patients, 52 (26%) had PE within 6 weeks; 42 (81%) were trivial-small and 10 (19%) were moderate-large. Twenty-nine (56%) were first detected within 7 days post-operatively, including all cases developing cardiac tamponade (n = 3). An echocardiogram was done 10 (± 2) days post-operatively in 41/52 cases, of which 12/41 (29%) did not have a PE at this time, 24/41 (59%) had a trivial-small PE, and 5/41(12%) had a moderate-large PE; 2 of the latter had no prior detected PE. Closure of an atrial septal defect had the highest incidence of PE (42%). PE cases were associated with postoperative nasopharyngeal detection of a respiratory virus (OR 3.8, p = 0.03). In conclusion, the majority of PE cases were detected within 7 days post-operatively, including all cases subsequently developing cardiac tamponade. Day 10 echocardiography infrequently detected a moderate or large effusion that had previously gone undiagnosed. A positive perioperative nasopharyngeal aspirate for a respiratory virus was associated with postoperative PE. |
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| MeSH term(s) | Cardiac Tamponade/diagnostic imaging ; Cardiac Tamponade/epidemiology ; Cardiac Tamponade/etiology ; Child ; Echocardiography ; Humans ; Pericardial Effusion/diagnostic imaging ; Pericardial Effusion/epidemiology ; Pericardial Effusion/etiology ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/epidemiology ; Retrospective Studies |
| Language | English |
| Publishing date | 2021-06-04 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 800857-7 |
| ISSN | 1432-1971 ; 0172-0643 |
| ISSN (online) | 1432-1971 |
| ISSN | 0172-0643 |
| DOI | 10.1007/s00246-021-02637-7 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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