Key result
Fever within 48 hours of surgical ASD closure is linked to ~350% higher pericardial effusion risk.
Why the study?
To evaluate the incidence of pericardial effusion after surgical atrial septal defect closure and investigate predictive risk factors for its development.
What are the incidence and predictors of pericardial effusion following surgical closure of atrial septal defect in children?
Cohort (n=200)
No
What are the incidence and predictors of pericardial effusion following surgical closure of atrial septal defect in children?
Fever within 48 hours and ST-segment elevation at discharge strongly predict the development of pericardial effusion after surgical ASD closure in children.
May warrant closer effusion surveillance after pediatric ASD repair; leaves open need for prospective validation of predictors.
Objectives To evaluate the incidence of pericardial effusion (PE) after surgical atrial septal defect (ASD) closure and to investigate the presence of predictive risk factors for its development. Methods We collected data from 203 patients followed at Bambino Gesù Children’s Hospital of Rome who underwent cardiac surgery for ASD repair between January 2015 and September 2019. Results A total of 200/203 patients with different types of ASD were included. Patients were divided into two groups: Group 1) 38 (19%) who developed PE and Group 2) 162 (81%) without PE. No differences were noted between the two groups with regard to gender or age at the surgery. Fever in the 48 h after surgery was significantly more frequent in group 1 than in group 2 (23.7 vs. 2.5%; p < 0.0001). ECG at discharge showed significant ST-segment elevation in children who developed PE, 24.3 vs. 2.0% in those who did not ( p < 0.0001). Group 1 patients were divided into two subgroups on the basis of the severity of PE, namely, 31 (81.6%) with mild and 7 (18.4%) with moderate/severe PE. Patients with moderate/severe PE had a significantly higher BMI value (median 19.1 Kg/m 2 ) (range 15.9–23.4, p = 0.004). Conclusion The presence of fever and ST-segment elevation after surgery predicts subsequent development of PE suggesting a closer follow-up for these categories of patients. A higher BMI appears to be associated with a higher risk of moderate/severe PE.
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Campisano et al. (2022) conducted a cohort in Atrial septal defect (n=200). Fever within 48 hours post-surgery vs. No fever within 48 hours post-surgery was evaluated on Incidence of pericardial effusion (RR 4.5, 95% CI 2.7-7.3, p=<0.0001). Fever in the 48 hours after surgical closure of atrial septal defect in children significantly increased the risk of developing pericardial effusion (RR 4.5).
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