Post-cardiac Surgery Chylopericardium.

J Coll Physicians Surg Pak

Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, China.

Published: June 2020

AI Article Synopsis

  • Post-cardiac surgery chylopericardium is a rare complication primarily seen in patients who have undergone surgery for congenital heart defects, especially those with more complex conditions.
  • A significant number of patients (29.4%) experienced cardiac tamponade, and the condition typically developed earlier in patients with acquired heart defects compared to those with congenital issues.
  • Most cases can be successfully managed with conservative treatment, although larger and rapidly accumulating chylopericardium may require further surgical intervention, with a low overall mortality rate observed in this study.

Article Abstract

Post-cardiac surgery chylopericardium is a rare complication. This systematic review included 87 articles with 119 patients of post-cardiac surgery chylopericardium. Chylopericardium developed after operations for congenital heart defect more than those for acquired heart disease, and more patients in whom post-cardiac surgery chylopericardium developed were with complex than with simple congenital heart defects. Cardiac tamponade occurred in 35 (29.4%) patients. The onset time of chylopericardium was 18.2 days earlier in patients operated for acquired than in those for congenital heart defects. Post-cardiac surgery chylopericardium were curable to conservative treatment in most patients. The recurrence of post-cardiac surgery chylopericardium was on day 13.2 ±18.2 after the initial treatment. The overall early and late mortality rates were 1.7% (2/119) and 1.7% (2/117), respectively. Most patients with post-cardiac surgery chylopericardium were diagnosed by laboratory analysis of chylous fluid. Patients with mild chylopericardium usually show good response to conservative treatment. Whereas, patients with massive chylopericardium and rapid accumulation, incurable to conservative treatment and recurrent to either conservative or surgical treatment, warrant further surgical treatment. Key Words: Cardiac surgical procedures, Pericardial effusion, Postoperative complications.

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Source
http://dx.doi.org/10.29271/jcpsp.2020.06.627DOI Listing

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