Pericardial Effusion After Pediatric Cardiac Surgeries: A Single Center Observation

Development of fibrinous pericarditis after pericardiotomy is a well-recognized reaction. Within a few post-operative days, the inflammated surface of pericardium begins to fuse to the overlying sternum. Our aim was to assess the prevalence, risk factors, time course and therapy response of pericardial effusion (PE) after cardiac surgeries in children.Patients and PE occurrence was assessed prospectively in 486 children who underwent cardiac surgery for congenital heart diseases by serial echocardiography. Clinical manifestations were observed and response to different therapies was analyzed. The prevalence of PE was about 10% for all cardiac surgeries. Symptoms were exclusively seen in patients who had moderate to large effusions. The mean onset of pericardial effusion was 11 (± 8) days after surgery procedure, with 87 % (42 of 48) of cases being diagnosed on or before day 13 after operation. The prevalence of effusion after Fontan-type procedures and AVSD repair (29 %, 5 of 17 for both) was significantly higher than other types of cardiac surgeries. Aspirin administration was effective in 77 % and prednisone in 90 % of the cases. PE may be developed as late as weeks after cardiac surgeries. PE after palliative cardiac surgeries is not uncommon. Low doses of aspirin and corticosteroids are usually effective for treating this complication... Implication for health policy/practice/research/medical education:Serial echocardiography may be needed in selected at-risk patients up to one month. Namely those with symptoms suggestive of postpericardiotomy syndrome and those after Fontan-type procedures and AVSD repair. Incidence of PE after palliative heart surgeries is considerable; following, such patients susceptible to PE should not be missed. Low doses of aspirin and corticosteroids may be effective in management of post-op pericardial effusions. A well designed Multi-center study could be helpful to bypass some study limitations and to provide a guideline for better approach to Post Pericardiotomy Effusion in children.