Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement
| Autor: | Fausto Biancari, K.E. Juhani Airaksinen, Markus Malmberg, Ville Kytö, Tuomas Kiviniemi, Juha Hartikainen, Tuomo Nieminen, Jarmo Gunn, Rikhard Björn, Joonas Lehto |
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| Přispěvatelé: | HUS Internal Medicine and Rehabilitation, Department of Medicine, South Carelia Social and Health care District Eksote, Päijät-Häme Welfare Consortium |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Heart Valve Diseases pericardium 030204 cardiovascular system & hematology 0302 clinical medicine Postoperative Complications Aortic valve replacement Interquartile range Risk Factors Postpericardiotomy Syndrome Medicine Prospective Studies Stroke health care economics and organizations Finland Incidence Hazard ratio Thoracic Surgery Atrial fibrillation Middle Aged thoracic surgery 3. Good health Cardiac surgery Survival Rate Aortic Valve Cardiology Female Cardiology and Cardiovascular Medicine Pericardium Pulmonary and Respiratory Medicine medicine.medical_specialty education postpericardiotomy syndrome 03 medical and health sciences Internal medicine Humans Cardiac Surgical Procedures Mortality Adverse effect Aged business.industry Postpericardiotomy syndrome medicine.disease 3126 Surgery anesthesiology intensive care radiology mortality adverse events 030228 respiratory system Adverse events Surgery business Follow-Up Studies Forecasting |
| Popis: | Objectives Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive interventions are scarce. Methods We sought to assess the occurrence of mortality, new-onset atrial fibrillation (AF), cerebrovascular events, and major bleeds in PPS patients requiring medical attention in a combination database of 671 patients who underwent isolated surgical aortic valve replacement with a bioprosthesis (n = 361) or mechanical prosthesis (n = 310) between 2002 and 2014 (Cardiovascular Research Consortium—A Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients [CAREBANK] 2016-2018). PPS was defined as moderate if it resulted in delayed hospital discharge, readmission, or medical therapy because of the symptoms; and severe if it required interventions for the evacuation of pleural or pericardial effusion. Results The overall incidence of PPS was 11.2%. Median time to diagnosis was 16 (interquartile range, 11-36) days. Severe PPS was diagnosed in 3.6% of patients. Severe PPS seemed to be associated with higher mortality (hazard ratio, 2.01; 95% confidence interval, 1.03-3.91; P = .040). Moderate or severe PPS increased the risk of new-onset AF during the early postoperative period (hazard ratio, 1.72; 95% confidence interval, 1.12-2.63; P = .012). No significant associations were found between PPS and cerebrovascular events or major bleeds during the follow-up. Conclusions Patients with PPS requiring invasive interventions are at increased risk for mortality unlike those with mild to moderate forms of the disease. PPS requiring medical attention is associated with a higher AF rate during the early postoperative period but has no significant effect on the occurrence of major stroke, stroke or transient ischemic attack, or major bleeds during long-term follow-up. |
| Databáze: | OpenAIRE |
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