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Risk factors for the development of postpericardiotomy syndrome.


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Department of Pediatric Cardiology - Philippine Heart Center

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Publication Type
Research Project


Charts of patients who underwent cardiac surgery and were diagnosed to have Postpericardiotomy Syndrome from 1995-1998 were reviewed. Symptoms of fever occured in 7 o 13 patients (53.85%). Pericardial friction rub was noted in one patient. Leukocytosis was present in 7 of 13 patients (53.85%). Pericardial effusion was present in all patients with postpericardiotomy syndrome and was initially seen in 2-dimensional echocardiogram as mild in 7 patients (53.85%), moderate in 4 patients (30.76%) and severe in 2 patients (15.38%) necessitating pericardiostomy tube insertion in these 2 patients. Pericardial fluid cultures taken from these two patients were negative. The pericardial effusions resolved spontaneously. Aspirin was given in 10 patients. Chest x-ray showed enlarged cardiac silhouette  all patients with postpericardiotomy syndrome. Majority of the patients in this study no fever but still had the postpericardiotomy syndrome. The presence of leucocytosis was present in the majority of patients with postpericardiotomy syndrome in this study. However the syndrome was also present in patients without leucocytosis. Electrocardographic changes were present in two patients who developed severe pericardial effusion. In a study done by Clapp, et al in 1980, they have seen the presence of pericardial effusion in 19/40 patients by the 5th postoperative day and the syndrome developed in 18 patients. In another study  by Komiya, et al in 1995 postoperative pericardial occured in 57% of their patients and later had postpericardiotomy syndrome. The presence of multiple cardiac lesions involving multiple repair of caridac lesions, fever, leucocytosis, associated preoperative history of infections, echocardiographic finding of perardial effusion are risk factors in the development of postpericardiotomy syndrome. It is recommended by this study that the presence of the above signs and symptoms would identify patients with the pericardiotomy.



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Philippine Heart Center Medical Library PHC.R.068.99 Fulltext Print Format

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