Postpericardiotomy syndrome following temporary and permanent transvenous pacing. (1/14)
The postpericardiotomy syndrome may occur as a complication of temporary and permanent pacing. Physicians involved in procedures which may be complicated by this condition therefore need to be aware of its diagnosis and management. (+info)Immune consequences of pediatric and adult cardiovascular surgery: report of the 7th Leipzig workshop. (2/14)
Cardiovascular surgery in children and adults is among the most common types of interventions in the western hemisphere for innate and acquired defects. In the recent decades, the risk of cardiovascular surgery has been reduced substantially. Nevertheless, open heart surgery is risky for the patient and can lead to postoperative complications such as postpericardiotomy syndrome, capillary leak syndrome, or multiple organ failure. To gain further understanding into the response to cardiovascular surgery, it is necessary to join forces from several disciplines of medicine and natural sciences. Interdisciplinarity is the basic concept of the Leipzig Workshop. The consensus of the workshop was that cardiovascular surgery with cardiopulmonary bypass induces a systemic antiinflammatory response due to (a) elimination of activated cells, (b) compensatory reaction to a local proinflammatory responses, (c) interleukin-10 release, (d) anesthetics and medication, and (e) leukocyte extravasation. The subsequent proinflammatory reaction is the response to surgical trauma modulating the antiinflammatory reaction. Novel therapeutic approaches include the introduction of autologous endothelial progenitor cells from the peripheral blood into the sites of injury. The analysis of immune response and outcome prediction require novel analytical tools that allow fast, accurate, and quantitative determination of the desired parameters in a multiplexed manner (i.e., cytomics), such as flow cytometric microbead array assays and slide-based cytometry. The major goal is predictive medicine by cytomics, i.e., the individualized risk assessment by analyzing the cytome in combination with sophisticated data pattern recognition. These developments may lead to individualized therapy for the benefit of the patient and cost reduction. (+info)Behavior of inflammatory markers of myocardial injury in cardiac surgery: laboratory correlation with the clinical picture of postpericardiotomy syndrome. (3/14)
OBJECTIVE: To verify the association of serum markers of myocardial injury, such as troponin I, creatinine kinase, and creatinine kinase isoenzyme MB, and inflammatory markers, such as tumor necrosis factor alpha (TNF-alpha), C-reactive protein, and the erythrocyte sedimentation rate in the perioperative period of cardiac surgery, with the occurrence of possible postpericardiotomy syndrome. METHODS: This was a cohort study with 96 patients undergoing cardiac surgery assessed at the following 4 different time periods: the day before surgery (D0); the 3rd postoperative day (D3); between the 7th and 10th postoperative days (D7-10); and the 30th postoperative day (D30). During each period, we evaluated demographic variables (sex and age), surgical variables (type and duration, extracorporeal circulation), and serum dosages of the markers of myocardial injury and inflammatory response. RESULTS: Of all patients, 12 (12.5%) met the clinical criteria for a diagnosis of postpericardiotomy syndrome, and their mean age was 10.3 years lower than the age of the others (P=0.02). The results of the serum markers for tissue injury and inflammatory response were not significantly different between the 2 assessed groups. No significant difference existed regarding either surgery duration or extracorporeal circulation. CONCLUSION: The patients who met the clinical criteria for postpericardiotomy syndrome were significantly younger than the others were. Serum markers for tissue injury and inflammatory response were not different in the clinically affected group, and did not correlate with the different types and duration of surgery or with extracorporeal circulation. (+info)COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS): a multicentre, randomized, double-blind, placebo-controlled trial. (4/14)
(+info)Colchicine as an effective treatment for postpericardiotomy syndrome following a lung lobectomy. (5/14)
(+info)Recurrent pericardial effusion after cardiac surgery: the use of colchicine after recalcitrant conventional therapy. (6/14)
(+info)Development of post-pericardiotomy syndrome is preceded by an increase in pro-inflammatory and a decrease in anti-inflammatory serological markers. (7/14)
(+info)Rheumatic symptoms after cardiac surgery: a prospective study. (8/14)
The incidence of different types of shoulder pain after open heart surgery was studied prospectively. Of 101 patients studied, 45 developed rheumatic symptoms during the first six weeks after the operation. Thirty eight patients reported pain in the region of the shoulder girdle with no loss of shoulder function (postpericardiotomy rheumatism). Three of these patients also had features compatible with the postpericardiotomy syndrome (fever, malaise, or pleuritic chest pain), and seven developed the syndrome without pain in the shoulder girdle. Of these 10 patients, one had generalised myalgia. Postpericardiotomy rheumatism alone was not associated with increased inflammation (measured by the erythrocyte sedimentation rate and concentration of C reactive protein); immunological tests including measurement of antibodies to cardiac muscle yielded inconclusive results. Replies to a postal questionnaire showed that symptoms of postpericardiotomy rheumatism were present for over three months in 18 patients and for six months or longer in 14. In view of the large number of patients now having open heart surgery postpericardiotomy rheumatism should be considered when patients report pain around the shoulders so that it is not misdiagnosed as angina. (+info)Postpericardiotomy Syndrome is a clinical entity characterized by fever, pleural or pericardial effusions, and occasionally pericarditis, occurring after cardiac surgery, which is believed to be an immune-mediated response to irritation of the pericardium during the surgical procedure.
Postpericardiotomy Syndrome (PPS) is a clinical entity that can occur after cardiac surgical procedures. It is characterized by the presence of pericardial effusion, pleural effusion, and/or inflammation of the serosal surfaces lining the heart and chest cavity (pericardium and pleura). The symptoms typically develop within 1-6 weeks after surgery and include fever, chest pain, and signs of fluid accumulation in the pericardial or pleural spaces.
The exact cause of PPS is not fully understood, but it is thought to be related to an immune response to the surgical trauma, leading to inflammation and increased production of cytokines and other mediators. The diagnosis of PPS is typically made based on clinical criteria, including the presence of fever, pleural or pericardial effusion, and evidence of inflammation. Treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or colchicine to reduce inflammation and relieve symptoms. In severe cases, drainage of the effusions may be necessary.