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 language | English |
|---|---|
| Pages (from-to) | 327-331 |
| Number of pages | 5 |
| Journal | Heart |
| Volume | 72 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1994 |
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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 journal › Article
}
TY - JOUR
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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UR - http://www.scopus.com/inward/citedby.url?scp=0028148598&partnerID=8YFLogxK
U2 - 10.1136/hrt.72.4.327
DO - 10.1136/hrt.72.4.327
M3 - Article
C2 - 7833189
AN - SCOPUS:0028148598
VL - 72
SP - 327
EP - 331
JO - Heart
JF - Heart
SN - 1355-6037
IS - 4
ER -