Echocardiography-guided pericardiocentesis as the method of choice for treatment of significant pericardial effusion following cardiac surgery: a 12-year single-center experience

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F17%3AE0106474" target="_blank" >RIV/00843989:_____/17:E0106474 - isvavai.cz</a>

Výsledek na webu

<a href="http://dx.doi.org/10.23736/S0026-4725.17.04331-6" target="_blank" >http://dx.doi.org/10.23736/S0026-4725.17.04331-6</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.23736/S0026-4725.17.04331-6" target="_blank" >10.23736/S0026-4725.17.04331-6</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Echocardiography-guided pericardiocentesis as the method of choice for treatment of significant pericardial effusion following cardiac surgery: a 12-year single-center experience

Popis výsledku v původním jazyce

BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis following cardiac surgery in Europe. The aim of the study was to review tertiary cardiac surgery center experience with postoperative pericardial effusion (PE) diagnosis and treatment. METHODS: A total of 6830 patients underwent open-heart surgery at our center between December 2004 and November 2016. Of these patients, 208 (3%) required pericardiocentesis for significant PE. RESULTS: There was a significant reduction of the incidence of substantial PE requiring pericardiocentesis by use of alternative surgical pericardial cavity drainage system (the accessory Redon drain positioned along the diaphragmatic surface of the heart) compared to conventional retrosternal chest tube drainage (3.3% vs. 2.1%). The rate/relative risk of pericardiocentesis was significantly higher after valve surgery, aortic root and ascending aorta surgery, and surgical ablation of atrial fibrillation-i.e. among patients who had received postoperative anticoagulation therapy. Clinical manifestations of cardiac tamponade were observed in 36% of patients, while progressive large PE without tamponade was evacuated in 41% of patients. Initial echo-guided pericardiocentesis was therapeutically effective in 98.6% of cases, and the rate of major complications was 1%. There was no mortality related to pericardiocentesis. Eighteen patients (8.7%) required repeated pericardiocenteses due to recurrent effusion. Fifteen patients (7.2%) in the pericardiocentesis group required surgery due to recurrent effusion, persistent bleeding, or clotted hemopericardium. CONCLUSIONS: Echo-guided pericardiocentesis was very effective and safe method for primary treatment of postoperative PE. Most patients did not require further intervention after this treatment.

Název v anglickém jazyce

Echocardiography-guided pericardiocentesis as the method of choice for treatment of significant pericardial effusion following cardiac surgery: a 12-year single-center experience

Popis výsledku anglicky

BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis following cardiac surgery in Europe. The aim of the study was to review tertiary cardiac surgery center experience with postoperative pericardial effusion (PE) diagnosis and treatment. METHODS: A total of 6830 patients underwent open-heart surgery at our center between December 2004 and November 2016. Of these patients, 208 (3%) required pericardiocentesis for significant PE. RESULTS: There was a significant reduction of the incidence of substantial PE requiring pericardiocentesis by use of alternative surgical pericardial cavity drainage system (the accessory Redon drain positioned along the diaphragmatic surface of the heart) compared to conventional retrosternal chest tube drainage (3.3% vs. 2.1%). The rate/relative risk of pericardiocentesis was significantly higher after valve surgery, aortic root and ascending aorta surgery, and surgical ablation of atrial fibrillation-i.e. among patients who had received postoperative anticoagulation therapy. Clinical manifestations of cardiac tamponade were observed in 36% of patients, while progressive large PE without tamponade was evacuated in 41% of patients. Initial echo-guided pericardiocentesis was therapeutically effective in 98.6% of cases, and the rate of major complications was 1%. There was no mortality related to pericardiocentesis. Eighteen patients (8.7%) required repeated pericardiocenteses due to recurrent effusion. Fifteen patients (7.2%) in the pericardiocentesis group required surgery due to recurrent effusion, persistent bleeding, or clotted hemopericardium. CONCLUSIONS: Echo-guided pericardiocentesis was very effective and safe method for primary treatment of postoperative PE. Most patients did not require further intervention after this treatment.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Minerva cardioangiologica

ISSN

0026-4725

e-ISSN

1827-1618

Svazek periodika

65

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

IT - Italská republika

Počet stran výsledku

12

Strana od-do

336-347

Kód UT WoS článku

000410709800002

EID výsledku v databázi Scopus

2-s2.0-85021230555