The postpericardiotomy syndrome is a febrile illness with pericardial and pleural reaction that either persists or appears beyond the 1st postoperative week. We believe that it begins in the 1st week after intrapericardial cardiac surgery, and that clinical signs of illness correlate with appearance of AHA and with significant rise in titer to AVA. Our present working hypothesis is that myocardial damage with bleeding into the pericardial sac at the time of surgery combines with concurrently acquired or reactivated viral illness to set the stage for the syndrome. The immune response is triggered by viral invasion of traumatized myocardium and an immune response is mounted, not against autologous myocardium per se but against the neo-antigen, the virus-infected myocardium. The illness is self-limited. It sometimes recurs but it seems to leave no sequelae other than the bad memory of a painful postoperative complication that prolonged hospitalization and delayed the realization of the full benefits of that heart operation.
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Division of Cardiology, McGill University Health Centre, 845 Rue Sherbrooke O, Montreal, QC, H3H 0G4, Canada.
Purpose Of Review: This review aims to evaluate current diagnostic and therapeutic strategies for postpericardiotomy syndrome (PPS), with a focus on the evolving role of multimodality imaging, including echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance imaging (CMR). The review also explores the potential benefits of advanced imaging in improving the accuracy and management of PPS.
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We appreciate the concerns raised by Ali. As well recognized, Post-Pericardiotomy Syndrome (PPS) has been a very difficult syndrome to classify and understand in part relating to variable methodologic approaches in the literature, and any attempts to clarify and unify methodology will only aid in better understanding this entity. Below is a point-by-point response to concerns raised.
View Article and Find Full Text PDFComment on: Early Post-operative ECG Changes as a Predictor of Post-pericardiotomy Syndrome Following Atrial Septal Defect Repair.
Pediatr Cardiol
November 2024
CMH Multan Institute of Medical Sciences, Multan, Pakistan.
Article Synopsis
- The article critiques Hyberg et al.'s study on early ECG changes predicting postoperative complications after atrial septal defect repair, expressing appreciation for their insights.
- The author raises concerns about the methodology, particularly the use of ESC criteria without pediatric-specific considerations and the narrow focus on certain ECG indicators.
- Suggestions for future research include incorporating standardized timing for ECGs and addressing independent risk factors for Post-Pericardiotomy Syndrome to enhance diagnostic strategies.
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