Vnitr Lek 2008, 54(4):334-340

Pericardiocentesis after cardiac surgery - our experience

M. Kolek^*, R. Brát

Kardiochirurgické centrum FN Ostrava, prim. MUDr. Radim Brát, Ph.D.

Pericardial effusion after cardiac surgery is common, but only in a small part of patients it has progressive character and cardiac tamponade occurs. Accurate diagnosis and well-timed pericardiocentesis are necessary to effective management of this life threatening complication. The study aimed at presentation of our centre outcomes of echocardiographically-guided pericardiocentesis in patients after cardiac surgery.

Methods:
Between December 2005 and November 2007, 2,232 patients underwent open-heart surgery in our centre. At 48 (2.2%) of them pericardiocentesis for clinically significant pericardial effusion was performed.

Results:
Pericardiocentesis was significantly more frequent after valve surgery (7.1%, p < 0.001), aortic root surgery (8.2%, p < 0.001) and surgical ablation of atrial fibrillation (6.6%, p < 0.001), i.e. in patients who had received postoperative anticoagulation therapy. Echo-guided pericardiocentesis was technically and therapeutically successful in 100% of cases and no complications were registered. The time elapsed between surgery and puncture was in range 6 to 80 days (median, 13 days). The median volume initially aspirated was 450 ml (range, 50 to 1,550 ml). Forty five patients (93.8%) had extended catheter drainage with active suction, the median duration of the drainage was 1 day (range, 1 to 6 days), the mean volume of catheter drainage was 328 ml (median, 145 ml; range, 20 to 2,950 ml). Four patients (8.3%) required repeated pericardiocenteses because of recurrence of significant pericadial effusion. Extended pericardial catheter drainage (after initial evacuation of the effusion) was associated with a significant reduction of recurrence of significant pericadial effusion and with lower probability of repeated pericardiocentesis.
We can

conclude, echo-guided pericardiocentesis was effective and safe method for primary treatment of postoperative pericardial effusions.

Keywords: pericardial effusion; cardiac tamponade; pericardiocentesis; echocardiography; cardiac surgery

Received: January 3, 2008; Accepted: February 2, 2008; Published: April 1, 2008  Show citation