Risk factors of pericardial effusions need to be drained in patients following open heart surgery

Nguyen Ngoc Yen Tuyet, Le Kim Tuyen

Main Article Content

Abstract

Objectives: To define risk factors of pericardial effusions (PE) need to be drained in patients following open-heart surgery (OHS) with pericardial opening.


Methods: A retrospective and prospective cohort study of 374 consecutive patients aged 18 years or older who underwent OHS with pericardial opening at the Heart Institute of  Ho Chi Minh City from July 1, 2019 to December 17, 2019. They are followed up for 6 months after surgery.


Results: the mean age: 50.3 ± 12.7, male 46.3%, female 53.7%. PE  needed to be drained 8.8% that included cardiac tamponade in 3,5% and nearly tamponade in 5.3%. The mean time from surgery to drain PE was 20,2 ± 10,8 days after operation. Univariable analyses demonstrated 5 risk factors correlated with PE needed to be drained following open-heart surgery: preoperative platelet level, new postoperative atrial fibrillation, preoperative NYHA group, the 2nd week and the 4th week after surgery. Multivariable analysis found 4 independent risk factors correlated with PE needed to be drained following open-heart surgery: preoperative platelet level, preoperative NYHA group, time of the pericardial drains removal and the 2nd week after surgery.


Conclusion: after open-heart surgery, large PE needed to be drained were 8.3%. Preoperative platelet level, preoperative NYHA group, time of the pericardial drains removal and the 2nd week after surgery were independent risk factors of PE needed to be drained.

Article Details

References

1. Chidambaram M., Akhtar M. J., al-Nozha M., et al. (1992). "Relationship of atrial fibrillation to significant pericardial effusion in valve-replacement patients". Thorac Cardiovasc Surg, 40 (2), pp. 70-3.
2. Floerchinger B., Camboni D., Schopka S., et al. (2013). "Delayed cardiac tamponade after open heart surgery - is supplemental CT imaging reasonable?". J Cardiothorac Surg, 8, pp. 158.
3. Khan N. K., Järvelä K. M., Loisa E. L., et al. (2017). "Incidence, presentation and risk factors of late postoperative pericardial effusions requiring invasive treatment after cardiac surgery". Interact Cardiovasc Thorac Surg, 24 (6), pp. 835-840.
4. Malouf j. F., Alam S., Stefadouros M. A. (1993). "The role of anticoagulation in the development of pericardial effusion and late tamponade after cardiac surgery". European Heart Journal, 14 (11), pp. 1451-1457.
5. Nguyen H. S., Nguyen H. D., Vu T. D. (2018). "Pericardial effusion following cardiac surgery. A single-center experience". Asian Cardiovasc Thorac Ann, 26 (1), pp. 5-10.