XXXX after cardiac surgery: incidence, site, size, and haemodynamic consequences.

@entity1 @entity358 @entity2293 @entity2294
OBJECTIVE: To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. DESIGN: Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of @entity1 with moderate or large pericardial effusion after operation. SETTING: @entity1 undergoing cardiac surgery at a tertiary centre. @entity1 : 803 consecutive @entity1 who had coronary artery bypass grafting (430), valve replacement (330), and other types of surgery (43). 23 were excluded because of early reoperation. MAIN OUTCOME MEASURES: Size and site of pericardial effusion evaluated by cross sectional echocardiography and signs of @entity2293 by ultrasound (right atrial and ventricular diastolic collapse, left ventricular diastolic collapse, distension of the inferior vena cava), and Doppler echocardiography (inspiratory decrease of aortic and mitral flow velocities). RESULTS: @entity2294 was detected in 498 (64%) of 780 @entity1 and was more often associated with coronary artery bypass grafting than with valve replacement or other types of surgery; it was small in 68.4%, moderate in 29.8%, and large in 1.6%. Loculated effusions (57.8%) were more frequent than diffuse ones (42.2%). The size and site of effusion were related to the type of surgery. None of the small pericardial effusions increased in size; the amount of fluid decreased within a month in most @entity1 with moderate effusion and in a few (7 @entity1 ) developed into a large effusion and @entity2293 individuals (1.9%) had @entity2293 ; this event was significantly more common after valve replacement (12 @entity1 ) than after coronary artery bypass grafting (2 @entity1 ) or other types of surgery (1 @entity1 after @entity358 ). In @entity1 with @entity2293 and mitral flow velocities invariably decreased during inspiration; the echocardiographic signs were less reliable. CONCLUSIONS: @entity2294 after cardiac surgery is common and its size and site are related to the type of surgery. @entity2293 is rare and is more common in @entity1 receiving oral anticoagulants. Echo-Doppler imaging is useful for the evaluation of @entity2294 after cardiac surgery. It can identify effusions that herald @entity2293 .
