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Year 2020 Vol. 28 No 5

LECTURES, REVIEWS

R.N. KOMAROV, N.O. KURASOV, A.M. ISMAILBAEV, A.O. DANACHEV

SYNDROME OF PERICARDIAL EXTENSION AND CARDIAC TAMPONADE AFTER OPEN CARDIOSURGICAL INTERVENTIONS

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow,
The Russian Federation

Postoperative effusion in the pericardium, which is also defined as postpericardial syndrome, is a common complication after open heart surgery. This condition directly affects the duration of hospitalization and the costs spent on treatment, and can also lead to life-threatening complications. Postoperative effusion in the pericardium can vary from slight (66-84%) to severe, defined as a cardiac tamponade (2.6%). The aim of this review is to consider etiopathogenesis, major risk factors, prevention and treatment of postoperative pericardial effusion. The development of cardiac tamponade is directly correlated with the type of intervention: 1.3% – after coronary artery bypass graft, 6.6% – after 1 valve replacement, 4.3% – after several valves replacement, 2.5% – after combined valve replacement and coronary artery bypass graft, 9.3% after thoracic aorta surgeries. The highest risk for developing cardiac tamponade accompanies patients after heart transplantation, interventions on the thoracic aorta and mechanical valve prosthetics. A proven and effective drug treatment strategy for the postoperative pericardial effusion syndrome is a combination of NSAIDs and colchicine. The posterior pericardiotomy is an effective and safe method for the prevention of this complication, and the most priority way to treat cardiac tamponade is echocardiographically controlled pericardiocentesis.

Keywords: postoperative pericardial effusion, postpericardiotomy syndrome, cardiac tamponade, posterior pericardiotomy, pericardiocentesis
p. 577-590 of the original issue
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Address for correspondence:
119435, Russian Federation,
Moscow, Bolshaya Pirogovskaya str., 6-1,
I.M. Sechenov First Moscow
State Medical University,
the Faculty Surgery Department No1,
tel. +7 926 816-47-37,
e-mail: danachev@gmail.com,
Danachev Alexander O.
Information about the authors:
Komarov Roman N., MD, Head of the Faculty Surgery Department No1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-3904-6415
Kurasov Nikolay O., Assistant of the Faculty Surgery Dåpartment No1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0001-6269-2207
Ismailbaev Alisher M., PhD, Assistant of the Faculty Surgery Department No1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0001-8545-3276
Danachev Alexander O., the Three-Year Post-Graduate Student, the Faculty Surgery Department No1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0001-9296-3119
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