Pericardial effusion after cardiac surgery: Incidence, site, size, and haemodynamic consequences

Mauro Pepi, Manuela Muratori, Paolo Barbier, Elisabetta Doria, Vincenzo Arena, Marco Berti, Fabrizio Celeste, Marco Guazzi, Gloria Tamborini

Research output: Contribution to journalArticle

Abstract

Objective-To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. Design-Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of patients with moderate or large pericardial effusion after operation. Setting-Patients undergoing cardiac surgery at a tertiary centre. Patients-803 consecutive patients who had coronary artery bypass grafting (430), valve replacement (330), and other types of surgery (43). 23 were excluded because of early reoperation. Main outcome measures-Size and site of pericardial effusion evaluated by cross sectional echocardiography and signs of cardiac tamponade detected by ultrasound (right atrial and ventricular diastolic collapse, left ventricular diastolic collapse, distension of the inferior vena cava), and Doppler echocardiography (inspiratory decrease of aortic and mitral flow velocities). Results-Pericardial effusion was detected in 498 (64%) of 780 patients and was more often associated with coronary artery bypass grafting than with valve replacement or other types of surgery; it was small in 68-4%, moderate in 29*8%, and large in 16%. Loculated effusions (57.8%) were more frequent than diffuse ones (42.2%). The size and site of effusion were related to the type of surgery. None of the small pericardial effusions increased in size; the amount of fluid decreased within a month in most patients with moderate effusion and in a few (7 patients) developed into a large effusion and cardiac tamponade. 15 individuals (1.90/6) had cardiac tamponade; this event was significantly more common after valve replacement (12 patients) than after coronary artery bypass grafting (2 patients) or other types of surgery (1 patient after pulmonary embolectomy). In patients with cardiac tamponade aortic and mitral flow velocities invariably decreased during inspiration; the echocardiographic signs were less reliable. Conclusions-Pericardial effusion after cardiac surgery is common and its size and site are related to the type of surgery. Cardiac tamponade is rare and is more common in patients receiving oral anticoagulants. Echo-Doppler imaging is useful for the evaluation of pericardial fluid accumulations after cardiac surgery. It can identify effusions that herald cardiac tamponade.

Original languageEnglish
Pages (from-to)327-331
Number of pages5
JournalHeart
Volume72
Issue number4
DOIs
Publication statusPublished - 1994

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Pericardial Effusion
Thoracic Surgery
Hemodynamics
Cardiac Tamponade
Incidence
Coronary Artery Bypass
Embolectomy
Doppler Echocardiography
Inferior Vena Cava
Reoperation
Anticoagulants
Echocardiography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Gastroenterology
  • Cardiology and Cardiovascular Medicine

Cite this

Pericardial effusion after cardiac surgery : Incidence, site, size, and haemodynamic consequences. / Pepi, Mauro; Muratori, Manuela; Barbier, Paolo; Doria, Elisabetta; Arena, Vincenzo; Berti, Marco; Celeste, Fabrizio; Guazzi, Marco; Tamborini, Gloria.

In: Heart, Vol. 72, No. 4, 1994, p. 327-331.

Research output: Contribution to journalArticle

Pepi, Mauro ; Muratori, Manuela ; Barbier, Paolo ; Doria, Elisabetta ; Arena, Vincenzo ; Berti, Marco ; Celeste, Fabrizio ; Guazzi, Marco ; Tamborini, Gloria. / Pericardial effusion after cardiac surgery : Incidence, site, size, and haemodynamic consequences. In: Heart. 1994 ; Vol. 72, No. 4. pp. 327-331.
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title = "Pericardial effusion after cardiac surgery: Incidence, site, size, and haemodynamic consequences",
abstract = "Objective-To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. Design-Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of patients with moderate or large pericardial effusion after operation. Setting-Patients undergoing cardiac surgery at a tertiary centre. Patients-803 consecutive patients who had coronary artery bypass grafting (430), valve replacement (330), and other types of surgery (43). 23 were excluded because of early reoperation. Main outcome measures-Size and site of pericardial effusion evaluated by cross sectional echocardiography and signs of cardiac tamponade detected by ultrasound (right atrial and ventricular diastolic collapse, left ventricular diastolic collapse, distension of the inferior vena cava), and Doppler echocardiography (inspiratory decrease of aortic and mitral flow velocities). Results-Pericardial effusion was detected in 498 (64{\%}) of 780 patients and was more often associated with coronary artery bypass grafting than with valve replacement or other types of surgery; it was small in 68-4{\%}, moderate in 29*8{\%}, and large in 16{\%}. Loculated effusions (57.8{\%}) were more frequent than diffuse ones (42.2{\%}). The size and site of effusion were related to the type of surgery. None of the small pericardial effusions increased in size; the amount of fluid decreased within a month in most patients with moderate effusion and in a few (7 patients) developed into a large effusion and cardiac tamponade. 15 individuals (1.90/6) had cardiac tamponade; this event was significantly more common after valve replacement (12 patients) than after coronary artery bypass grafting (2 patients) or other types of surgery (1 patient after pulmonary embolectomy). In patients with cardiac tamponade aortic and mitral flow velocities invariably decreased during inspiration; the echocardiographic signs were less reliable. Conclusions-Pericardial effusion after cardiac surgery is common and its size and site are related to the type of surgery. Cardiac tamponade is rare and is more common in patients receiving oral anticoagulants. Echo-Doppler imaging is useful for the evaluation of pericardial fluid accumulations after cardiac surgery. It can identify effusions that herald cardiac tamponade.",
author = "Mauro Pepi and Manuela Muratori and Paolo Barbier and Elisabetta Doria and Vincenzo Arena and Marco Berti and Fabrizio Celeste and Marco Guazzi and Gloria Tamborini",
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T1 - Pericardial effusion after cardiac surgery

T2 - Incidence, site, size, and haemodynamic consequences

AU - Pepi, Mauro

AU - Muratori, Manuela

AU - Barbier, Paolo

AU - Doria, Elisabetta

AU - Arena, Vincenzo

AU - Berti, Marco

AU - Celeste, Fabrizio

AU - Guazzi, Marco

AU - Tamborini, Gloria

PY - 1994

Y1 - 1994

N2 - Objective-To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. Design-Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of patients with moderate or large pericardial effusion after operation. Setting-Patients undergoing cardiac surgery at a tertiary centre. Patients-803 consecutive patients who had coronary artery bypass grafting (430), valve replacement (330), and other types of surgery (43). 23 were excluded because of early reoperation. Main outcome measures-Size and site of pericardial effusion evaluated by cross sectional echocardiography and signs of cardiac tamponade detected by ultrasound (right atrial and ventricular diastolic collapse, left ventricular diastolic collapse, distension of the inferior vena cava), and Doppler echocardiography (inspiratory decrease of aortic and mitral flow velocities). Results-Pericardial effusion was detected in 498 (64%) of 780 patients and was more often associated with coronary artery bypass grafting than with valve replacement or other types of surgery; it was small in 68-4%, moderate in 29*8%, and large in 16%. Loculated effusions (57.8%) were more frequent than diffuse ones (42.2%). The size and site of effusion were related to the type of surgery. None of the small pericardial effusions increased in size; the amount of fluid decreased within a month in most patients with moderate effusion and in a few (7 patients) developed into a large effusion and cardiac tamponade. 15 individuals (1.90/6) had cardiac tamponade; this event was significantly more common after valve replacement (12 patients) than after coronary artery bypass grafting (2 patients) or other types of surgery (1 patient after pulmonary embolectomy). In patients with cardiac tamponade aortic and mitral flow velocities invariably decreased during inspiration; the echocardiographic signs were less reliable. Conclusions-Pericardial effusion after cardiac surgery is common and its size and site are related to the type of surgery. Cardiac tamponade is rare and is more common in patients receiving oral anticoagulants. Echo-Doppler imaging is useful for the evaluation of pericardial fluid accumulations after cardiac surgery. It can identify effusions that herald cardiac tamponade.

AB - Objective-To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. Design-Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of patients with moderate or large pericardial effusion after operation. Setting-Patients undergoing cardiac surgery at a tertiary centre. Patients-803 consecutive patients who had coronary artery bypass grafting (430), valve replacement (330), and other types of surgery (43). 23 were excluded because of early reoperation. Main outcome measures-Size and site of pericardial effusion evaluated by cross sectional echocardiography and signs of cardiac tamponade detected by ultrasound (right atrial and ventricular diastolic collapse, left ventricular diastolic collapse, distension of the inferior vena cava), and Doppler echocardiography (inspiratory decrease of aortic and mitral flow velocities). Results-Pericardial effusion was detected in 498 (64%) of 780 patients and was more often associated with coronary artery bypass grafting than with valve replacement or other types of surgery; it was small in 68-4%, moderate in 29*8%, and large in 16%. Loculated effusions (57.8%) were more frequent than diffuse ones (42.2%). The size and site of effusion were related to the type of surgery. None of the small pericardial effusions increased in size; the amount of fluid decreased within a month in most patients with moderate effusion and in a few (7 patients) developed into a large effusion and cardiac tamponade. 15 individuals (1.90/6) had cardiac tamponade; this event was significantly more common after valve replacement (12 patients) than after coronary artery bypass grafting (2 patients) or other types of surgery (1 patient after pulmonary embolectomy). In patients with cardiac tamponade aortic and mitral flow velocities invariably decreased during inspiration; the echocardiographic signs were less reliable. Conclusions-Pericardial effusion after cardiac surgery is common and its size and site are related to the type of surgery. Cardiac tamponade is rare and is more common in patients receiving oral anticoagulants. Echo-Doppler imaging is useful for the evaluation of pericardial fluid accumulations after cardiac surgery. It can identify effusions that herald cardiac tamponade.

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