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European Journal of Internal Medicine May 2024The management of even large pericardial effusions in asymptomatic patients is still a matter of debate. Aim of the present study is to explore, in a multicenter...
INTRODUCTION
The management of even large pericardial effusions in asymptomatic patients is still a matter of debate. Aim of the present study is to explore, in a multicenter setting, the rate of post-cardiac injury syndromes (PCIS) and pericardial effusion recurrence after pericardial effusion drainage procedure.
MATERIAL AND METHODS
This is a multicenter international retrospective study including a consecutive cohort of patients diagnosed with large, chronic and idiopathic pericardial effusions, prospectively evaluated from January 2003 to December 2021 who underwent a clinically indicated pericardial drainage procedure. Two separate end-points were recorded: 1) recurrence of pericardial effusion after drainage without any sign of pericardial inflammation 2) occurrence of PCIS, defined as the new onset of pericarditis 1 to 6 weeks after pericardial intervention.
RESULTS
124 patients were enrolled (50 % female, mean age 64 years old). A mean follow-up of 29.6 ± 25.6 months was obtained in 110 patients (88 %). 110 patients were treated with pericardiocentesis (89 %), 25 with pleuro-pericardial windows (20 %), and 1 with pericardiectomy (1 %). PCIS occurred in 21 out of 124 patients followed for at least 6 weeks (16.9%). Recurrence of pericardial effusion after drainage without any sign of pericardial inflammation occurred in 68 out of 110 patients at a longer follow-up (61.8 %). At multivariate analysis only inflammatory cells in pericardial fluid was associated with PCIS and pericardiocentesis with pericardial effusion recurrency.
CONCLUSION
Our data support the need of caution with the use of pericardiocentesis in asymptomatic patients with large pericardial effusion as it is often associated with pericardial effusion recurrence. Of interest the presence of inflammatory cells in the pericardial fluid is associated with PCIS after pericardial drainage procedures.
Topics: Humans; Pericardial Effusion; Female; Male; Middle Aged; Retrospective Studies; Aged; Recurrence; Drainage; Pericardiocentesis; Pericarditis; Pericardial Window Techniques; Pericardiectomy; Heart Injuries
PubMed: 38262844
DOI: 10.1016/j.ejim.2024.01.024 -
Asian Cardiovascular & Thoracic Annals Feb 2020
Topics: Drainage; Female; Humans; Lupus Erythematosus, Systemic; Middle Aged; Pericardial Effusion; Pericardial Window Techniques; Pericarditis; Thoracic Surgery, Video-Assisted; Treatment Outcome
PubMed: 31830421
DOI: 10.1177/0218492319896507 -
European Heart Journal. Cardiovascular... Apr 2020
Topics: Coronary Artery Disease; Humans; Pericardial Window Techniques; Pericardium; Registries; Ultrasonography
PubMed: 31642897
DOI: 10.1093/ehjci/jez274 -
Journal of Cardiothoracic and Vascular... May 2024
Topics: Humans; Pericardial Window Techniques; Intercostal Nerves; Pain, Postoperative
PubMed: 38453556
DOI: 10.1053/j.jvca.2024.02.002 -
Anatolian Journal of Cardiology May 2021
Topics: Cardiac Tamponade; Carotenoids; Heart Ventricles; Humans; Oxygenases; Pericardial Effusion; Pericardial Window Techniques
PubMed: 33960313
DOI: 10.14744/AnatolJCardiol.2020.37863