Incidence, predictors, and clinical outcomes of postoperative cardiac tamponade in patients undergoing heart valve surgery

Seng Chan You, ChiYoung Shim, Geu Ru Hong, Darae Kim, In Jeong Cho, Sak Lee, Hyuk-Jae Chang, Jong Won Ha, Byung Chul Chang, Namsik Chung

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage. The median time of pericardial drainage after surgery was 17 (interquartile range, IQR, 13-30) days. Infective endocarditis, mechanical valve replacement of aortic or mitral valve, and any amount of pericardial effusion (PE) on the first postoperative TTE were related to the occurrence of cardiac tamponade (all p<0.05). After multivariate adjustment, occurrence of cardiac tamponade was associated with any amount of PE on the first postoperative TTE (hazard ratio, HR, 14.00, p<0.001) and mechanical valve replacement (HR 2.69, p = 0.025). The mean hospital days in patients with cardiac tamponade was higher than those without (34.9 vs. 13.5, p = 0.031). After pericardial drainage, there was no echocardiographic recurrence of significant PE during a median of 34.8 (IQR 14.9-43.7) months after surgery. Cardiac tamponade after heart valve surgery is not uncommon. Patients with any amount of PE at the first postoperative TTE or mechanical valve replacement should receive higher attention with regard to the occurrence of cardiac tamponade. Although it prolongs hospital stay, cardiac tamponade exhibits a benign clinical course without recurrence after timely intervention.

Original languageEnglish
Article numbere0165754
JournalPLoS One
Volume11
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1

Fingerprint

heart valves
Cardiac Tamponade
Heart Valves
Echocardiography
Surgery
echocardiography
pericardial effusion
Thoracic Surgery
surgery
incidence
Pericardial Effusion
Incidence
Drainage
drainage
endocarditis
disease course
Recurrence
hemorrhage
Hazards
Endocarditis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

You, Seng Chan ; Shim, ChiYoung ; Hong, Geu Ru ; Kim, Darae ; Cho, In Jeong ; Lee, Sak ; Chang, Hyuk-Jae ; Ha, Jong Won ; Chang, Byung Chul ; Chung, Namsik. / Incidence, predictors, and clinical outcomes of postoperative cardiac tamponade in patients undergoing heart valve surgery. In: PLoS One. 2016 ; Vol. 11, No. 11.
@article{f2f5c29f8541466b84091ade75870985,
title = "Incidence, predictors, and clinical outcomes of postoperative cardiac tamponade in patients undergoing heart valve surgery",
abstract = "This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3{\%}) patients and all underwent surgical or percutaneous pericardial drainage. The median time of pericardial drainage after surgery was 17 (interquartile range, IQR, 13-30) days. Infective endocarditis, mechanical valve replacement of aortic or mitral valve, and any amount of pericardial effusion (PE) on the first postoperative TTE were related to the occurrence of cardiac tamponade (all p<0.05). After multivariate adjustment, occurrence of cardiac tamponade was associated with any amount of PE on the first postoperative TTE (hazard ratio, HR, 14.00, p<0.001) and mechanical valve replacement (HR 2.69, p = 0.025). The mean hospital days in patients with cardiac tamponade was higher than those without (34.9 vs. 13.5, p = 0.031). After pericardial drainage, there was no echocardiographic recurrence of significant PE during a median of 34.8 (IQR 14.9-43.7) months after surgery. Cardiac tamponade after heart valve surgery is not uncommon. Patients with any amount of PE at the first postoperative TTE or mechanical valve replacement should receive higher attention with regard to the occurrence of cardiac tamponade. Although it prolongs hospital stay, cardiac tamponade exhibits a benign clinical course without recurrence after timely intervention.",
author = "You, {Seng Chan} and ChiYoung Shim and Hong, {Geu Ru} and Darae Kim and Cho, {In Jeong} and Sak Lee and Hyuk-Jae Chang and Ha, {Jong Won} and Chang, {Byung Chul} and Namsik Chung",
year = "2016",
month = "11",
day = "1",
doi = "10.1371/journal.pone.0165754",
language = "English",
volume = "11",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "11",

}

Incidence, predictors, and clinical outcomes of postoperative cardiac tamponade in patients undergoing heart valve surgery. / You, Seng Chan; Shim, ChiYoung; Hong, Geu Ru; Kim, Darae; Cho, In Jeong; Lee, Sak; Chang, Hyuk-Jae; Ha, Jong Won; Chang, Byung Chul; Chung, Namsik.

In: PLoS One, Vol. 11, No. 11, e0165754, 01.11.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence, predictors, and clinical outcomes of postoperative cardiac tamponade in patients undergoing heart valve surgery

AU - You, Seng Chan

AU - Shim, ChiYoung

AU - Hong, Geu Ru

AU - Kim, Darae

AU - Cho, In Jeong

AU - Lee, Sak

AU - Chang, Hyuk-Jae

AU - Ha, Jong Won

AU - Chang, Byung Chul

AU - Chung, Namsik

PY - 2016/11/1

Y1 - 2016/11/1

N2 - This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage. The median time of pericardial drainage after surgery was 17 (interquartile range, IQR, 13-30) days. Infective endocarditis, mechanical valve replacement of aortic or mitral valve, and any amount of pericardial effusion (PE) on the first postoperative TTE were related to the occurrence of cardiac tamponade (all p<0.05). After multivariate adjustment, occurrence of cardiac tamponade was associated with any amount of PE on the first postoperative TTE (hazard ratio, HR, 14.00, p<0.001) and mechanical valve replacement (HR 2.69, p = 0.025). The mean hospital days in patients with cardiac tamponade was higher than those without (34.9 vs. 13.5, p = 0.031). After pericardial drainage, there was no echocardiographic recurrence of significant PE during a median of 34.8 (IQR 14.9-43.7) months after surgery. Cardiac tamponade after heart valve surgery is not uncommon. Patients with any amount of PE at the first postoperative TTE or mechanical valve replacement should receive higher attention with regard to the occurrence of cardiac tamponade. Although it prolongs hospital stay, cardiac tamponade exhibits a benign clinical course without recurrence after timely intervention.

AB - This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage. The median time of pericardial drainage after surgery was 17 (interquartile range, IQR, 13-30) days. Infective endocarditis, mechanical valve replacement of aortic or mitral valve, and any amount of pericardial effusion (PE) on the first postoperative TTE were related to the occurrence of cardiac tamponade (all p<0.05). After multivariate adjustment, occurrence of cardiac tamponade was associated with any amount of PE on the first postoperative TTE (hazard ratio, HR, 14.00, p<0.001) and mechanical valve replacement (HR 2.69, p = 0.025). The mean hospital days in patients with cardiac tamponade was higher than those without (34.9 vs. 13.5, p = 0.031). After pericardial drainage, there was no echocardiographic recurrence of significant PE during a median of 34.8 (IQR 14.9-43.7) months after surgery. Cardiac tamponade after heart valve surgery is not uncommon. Patients with any amount of PE at the first postoperative TTE or mechanical valve replacement should receive higher attention with regard to the occurrence of cardiac tamponade. Although it prolongs hospital stay, cardiac tamponade exhibits a benign clinical course without recurrence after timely intervention.

UR - http://www.scopus.com/inward/record.url?scp=84995654461&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995654461&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0165754

DO - 10.1371/journal.pone.0165754

M3 - Article

C2 - 27855225

AN - SCOPUS:84995654461

VL - 11

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

M1 - e0165754

ER -