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Incidence and factors associated with pericardial effusion after cardiac valve surgery

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Incidence and factors associated with pericardial effusion after cardiac valve surgery

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Título Incidence and factors associated with pericardial effusion after cardiac valve surgery
Autor Martins, Eduardo Ferreira
Pereira Neto, Adriano Heemann
Danielli, Lucas
Nunes, Lisandra Almeida
Amaral, Maria Vitória França do
Kalil, Paulo Sergio Abunader
Wender, Orlando Carlos Belmonte
Foppa, Murilo
Santos, Ângela Barreto Santiago
Abstract Introduction: Pericardial effusion (PE) is a postoperative complication of cardiac valve surgery, related to early hospital readmissions and death. We aimed to describe its incidence and to identify predictive factors of moderate-to-severe PE in a contemporary cohort. Methods: We retrospectively reviewed medical records of all consecutive patients submitted to cardiac valve surgery in a tertiary teaching hospital from January 2012 to July 2014, where echocardiography was routinely performed before patient discharge. Moderate-to-severe PE was defined as ≥ 10 mm of thickness, or signs of cardiac tamponade on echocardiography. Additional clinical and perioperative data were extracted from medical records using a standardized protocol. Results: Of 353 patients, 335 underwent a predischarge echocardiography. From these, 27 patients (8%; mean age: 62 years; standard deviation 12 years; 70% male) had moderate-to-severe PE. These patients had a higher prevalence of previous stroke (22% vs. 8%; p = 0.009) and oral anticoagulation (international normalized ratio > 2) prior to the surgery (11 vs. 2%; P = 0.002). In patients with moderate-to-severe PE, surgeries had longer ischemia (p < 0.001) and cardiopulmonary bypass (p < 0.001) times, and the prevalence of postoperative atrial fibrillation was higher (56% vs. 32%; p = 0.011) than in patients with absent or small PE. Hospital mortality was also higher (15% vs. 3%; p = 0.002) in patients with moderate-to-severe PE. Conclusions: Eight percent of patients submitted to cardiac valve surgery developed moderate-to-severe PE. Moreover, PE was associated with pre- and post-surgery conditions likely related to the coagulation state, though a cause-effect relationship could not be inferred. Noteworthy, this condition was associated with higher in-hospital morbidity and mortality.
Contido em Clinical and biomedical research. Porto Alegre. Vol. 37, n. 1 (2017), p. 18-24
Assunto Adulto
Cuidados pós-operatórios
Derrame pericárdico
[en] Adult
[en] Pericardium
[en] Postoperative care
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/166325
Arquivos Descrição Formato
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