medigraphic.com
Revista Médica Sinergia

2020, Number 11

<< Back Next >>

Revista Médica Sinergia 2020; 5 (11)

Postpericardiotomy syndrome: a clinical review

Murillo MAJ, Rodríguez BCR

Language: Spanish
References: 21
Page: 1-13
PDF size: 192.00 Kb.


ABSTRACT

Postpericardiotomy syndrome is considered a frequent complication in a subgroup of patients who undergo cardiac surgery. It is characterized by a pleuropericardial inflammatory response triggered by mechanical mesothelial damage secondary to a surgical procedure and an autoimmune component possibly implicated in its pathogenesis. Low concentrations of interleukin 8 and high of complement conversion products (C3bi and C3), in addition to low hemoglobin concentrations and a lower platelet count prior to surgery, as well as postsurgical transfusion of red blood cells, have been described as risk factors for this syndrome. The use of colchicine and medical treatment for diabetes are considered protective factors. Maintaining a high index of suspicion is essential, considering the factors related to the patient and the surgical procedure that are associated with an increased risk of developing postpericardiotomy syndrome, the individual characteristics of the patient and the variability of the clinical presentation in order to establish a timely diagnosis in addition to carry out an adequate risk stratification and thus define the optimal treatment strategy. The current European clinical practice guidelines propose a therapeutic scheme for the management of postpericardiotomy syndrome identical to that of acute pericarditis, whose main pillar is anti-inflammatory therapy with the aim of accelerating the remission of symptoms and reducing recurrences. Colchicine is the only therapeutic agent that has been shown to be safe and effective for primary prevention of postpericardiotomy syndrome, so current evidence recommends its prescription for 1 month in weight-adjusted doses similar to those used for acute pericarditis.


REFERENCES

  1. Tamarappoo B, Klein A. Post-pericardiotomy Syndrome. Curr Cardiol Rep. 2016; 18(116). https://doi.org/10.1007/s11886-016-0791-0

  2. Osch D, Nathoe H, Jacob K, Doevendans P, Dijk D, Suyker W, Dieleman J. Determinants of the postpericardiotomy syndrome: a systematic review. Eur J Clin Invest 2017; 47(6): 456–46. https://doi.org/10.1111/eci.12764

  3. Grupo de Trabajo de la Sociedad Europea de Cardiología (ESC) para el diagnóstico y tratamiento de las enfermedades del pericardio. Artículo especial Guía ESC 2015 sobre el diagnóstico y tratamiento de las enfermedades del pericardio: Grupo de Trabajo de la Sociedad Europea de Cardiología (ESC) para el diagnóstico y tratamiento de las enfermedades del pericardio. Rev Esp Cardiol. 2015; 68(12): 1126.e1- e46 https://doi.org/10.1016/j.recesp.2015.10.011

  4. Gabaldo K, Sutlić Z, Mišković D, Knežević M, Prvulović P, Vujeva B, Lukenda K, Hadžibegović I. Postpericardiotomy Syndrome Incidence, Diagnostic and Treatment Strategies: Experience at Two Collaborative Centers. Acta Clin Croat 2019; 58:57-62. https://doi.org/10.20471/acc.2019.58.01.08

  5. Yuan S. Postpericardiotomy Syndrome after Cardiac Operations. J Coll Physicians Surg Pak. 2020; 30(1):62-66. https://doi.org/10.29271/jcpsp.2020.01.62

  6. Lehto J, Kiviniemi T, Gunn J, Mustonen P, Airaksinen J, Biancari F, Rautava P, Sipilä J, Kytö V. Occurrence of postpericardiotomy síndrome admissions: A population-based registry study. Ann. Med. 2016; 48(1-2): 28-33. https://doi.org/10.3109/07853890.2015.1122223

  7. Lehto J, Gunn J, Karjalainen P, Airaksinen J, Kiviniemi T. Incidence and risk factors of postpericardiotomy syndrome requiring medical attention: The Finland postpericardiotomy syndrome study. J Thorac Cardiovasc Surg. 2015; 149(5): 1324– 1329. https://doi.org/10.1016/j.jtcvs.2015.01.031

  8. Osch D, Dieleman J, Bunge J, Dijk D, Doevendans P, Suyker W, Nathoe H. Risk factors and prognosis of postpericardiotomy syndrome in patients undergoing valve surgery. J Thorac Cardiovasc Surg. 2017;153(4):878-885e1. https://doi.org/10.1016/j.jtcvs.2016.10.075

  9. Chiabrando J, Bonaventura A, Vecchié A, Wohlford G, Mauro A, Jordan J, Grizzard J, Montecucco F, Berrocal D, Brucato A, Imazio M, Abbate A. Management of Acute and Recurrent Pericarditis. J Am Coll Cardiol. 2020; 75(1): 76-92. https://doi.org/10.1016/j.jacc.2019.11.021

  10. Chetrit M, Xu B, Kwon D, Ramchand J, Rodriguez R, Tan C, Jellis C, Johnston D, Renapurkar R, Cremer P, Klein A. Imaging-Guided Therapies for Pericardial Diseases. J Am Coll Cardiol. 2019. Epub 2019 Nov 13. https://doi.org/10.1016/j.jcmg.2019.08.027

  11. Lehto J, Kiviniemi T, Gunn J, Airaksinen J, Rautava P, Kyto V. Occurrence of Postpericardiotomy Syndrome: Association With Operation Type and Postoperative Mortality After Open-Heart Operations. J Am Heart Assoc. 2018; 7(22): e010269. https://doi.org/10.1161/JAHA.118.010269

  12. Lehto J, Gunn J, Bjorn R, Malmberg M, Airaksinen J, Kyto V, Nieminen T, Hartikainen J, Biancari F, Kiviniemi T. Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement. J Thorac Cardiovasc Surg. 2020; 0(0). Epub 2020 Ene 27. https://doi.org/10.1016/j.jtcvs.2019.12.114

  13. Fardman A, Charron P, Imazio M, Adler Y. European Guidelines on Pericardial Diseases: a Focused Review of Novel Aspects. Curr Cardiol Rep. 2016; 18(46). https://doi.org/10.1007/s11886-016-0721-1

  14. Cremer P, Kumar A, Kontzias A, Tan C, Rodriguez E, Imazio M, Klein A. Complicated Pericarditis: Understanding Risk Factors and Pathophysiology to Inform Imaging and Treatment. J Am Coll Cardiol. 2016; 68(21): 2311-2328. https://doi.org/10.1016/j.jacc.2016.07.785

  15. Imazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA. 2015; 314(14):1498-1506. https://doi.org/10.1001/jama.2015.12763

  16. Casanova P, Artola R, Mihos C, Pineda A, Santana O. The Cardiovascular Effects of Colchicine: A Comprehensive Review. Cardiology in Review. 2015; 23(6): 317–322. Disponible en: https://journals.lww.com/cardiologyinreview/Abstract/2015/11000/The_Cardiovascular_ Effects_of_Colchicine A.7.aspx

  17. Shah SR, Alweis R, Shah SA, Arshad M, Manji A, Arfeen A, Javed M, Shujauddin S, Irfan R, Shabbir S, Shaikh S. Effects of colchicine on pericardial diseases: a review of the literature and current evidence. Journal of Community Hospital Internal Medicine Perspectives. 2016; 6(3):31957. https://doi.org/10.3402/jchimp.v6.31957

  18. Lutschinger L, Rigopoulos A, Schlattmann P, Matiakis M, Sedding D, Schulze P, Noutsias M. Metaanalysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome. BMC Cardiovascular Disorders. 2019; 19(227). Corregido y republicado a partir de: BMC Cardiovascular Disorders. 2019; 19(207). https://doi.org/10.1186/s12872-019-1190-4.

  19. Papageorgiou N, Briasoulis A, Lazaros G, Imazio M, Tousoulis D. Colchicine for prevention and treatment of cardiac diseases: A meta-analysis. Cardiovascular Therapeutics. 2017; 35(1): 10–18. https://doi.org/10.1111/1755-5922.12226

  20. Sevuk U, Baysal E, Altindag R, Yaylak B, Adiyaman M, Ay N, Beyazit U, Alp V. Role of methylprednisolone in the prevention of postpericardiotomy syndrome after cardiac surgery. Eur Rev Med Pharmacol Sci. 2016; 20(3): 514-519. Disponible en: https://www.europeanreview.org/article/10290

  21. Wamboldt R, Bisleri G, Glover B, Haseeb S, Tse G, Liu T, Baranchuk A. Primary prevention of postpericardiotomy síndrome using corticosteroids: a systematic review. Expert Review of Cardiovascular Therapy. 2018; 16 (6):405-412. https://doi.org/10.1080/14779072.2018.1475231




2020     |     www.medigraphic.com