Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement

Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive interventions are scarce. We sought to assess the occurrence of mortality, new-onset atrial fibrillati...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of thoracic and cardiovascular surgery 2020-12, Vol.160 (6), p.1446-1456
Hauptverfasser: Lehto, Joonas, Gunn, Jarmo, Björn, Rikhard, Malmberg, Markus, Airaksinen, K.E. Juhani, Kytö, Ville, Nieminen, Tuomo, Hartikainen, Juha E.K., Biancari, Fausto, Kiviniemi, Tuomas O.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1456
container_issue 6
container_start_page 1446
container_title The Journal of thoracic and cardiovascular surgery
container_volume 160
creator Lehto, Joonas
Gunn, Jarmo
Björn, Rikhard
Malmberg, Markus
Airaksinen, K.E. Juhani
Kytö, Ville
Nieminen, Tuomo
Hartikainen, Juha E.K.
Biancari, Fausto
Kiviniemi, Tuomas O.
description Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive interventions are scarce. We sought to assess the occurrence of mortality, new-onset atrial fibrillation (AF), cerebrovascular events, and major bleeds in PPS patients requiring medical attention in a combination database of 671 patients who underwent isolated surgical aortic valve replacement with a bioprosthesis (n = 361) or mechanical prosthesis (n = 310) between 2002 and 2014 (Cardiovascular Research Consortium—A Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients [CAREBANK] 2016-2018). PPS was defined as moderate if it resulted in delayed hospital discharge, readmission, or medical therapy because of the symptoms; and severe if it required interventions for the evacuation of pleural or pericardial effusion. The overall incidence of PPS was 11.2%. Median time to diagnosis was 16 (interquartile range, 11-36) days. Severe PPS was diagnosed in 3.6% of patients. Severe PPS seemed to be associated with higher mortality (hazard ratio, 2.01; 95% confidence interval, 1.03-3.91; P = .040). Moderate or severe PPS increased the risk of new-onset AF during the early postoperative period (hazard ratio, 1.72; 95% confidence interval, 1.12-2.63; P = .012). No significant associations were found between PPS and cerebrovascular events or major bleeds during the follow-up. Patients with PPS requiring invasive interventions are at increased risk for mortality unlike those with mild to moderate forms of the disease. PPS requiring medical attention is associated with a higher AF rate during the early postoperative period but has no significant effect on the occurrence of major stroke, stroke or transient ischemic attack, or major bleeds during long-term follow-up. Patients with severe PPS were at increased risk for mortality. A transient increased risk of new-onset AF was observed, but PPS had no effect on the occurrence of cerebrovascular events or major bleeds. [Display omitted]
doi_str_mv 10.1016/j.jtcvs.2019.12.114
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2369405590</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522320302312</els_id><sourcerecordid>2369405590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-d4e18e13de44921e2adb8d53c610a78295595f74999a9550e65f9b0de35c95613</originalsourceid><addsrcrecordid>eNp9kMtKAzEUhoMotl6eQJAs3cyYy2TaLFyIeIOCGwV3IU3OaMrMZEzSkb69qVWXrnIg3_8fzofQGSUlJbS-XJWrZMZYMkJlSVlJabWHppTIWVHPxes-mhLCWCEY4xN0FOOKEDLL7CGacEbzyNkU2Ws7QoiAYYQ-Rax7i-M6jG7ULf506R0PPqYBgjM6WOeT7zY4bnobfAdYNwnCln_L3y3WPiRncI6OgAMMrTbQ5doTdNDoNsLpz3uMXu5un28eisXT_ePN9aIwFalSYSugc6DcQlVJRoFpu5xbwU1NiZ7NmRRCimZWSSl1ngnUopFLYoELI0VN-TG62PUOwX-sISbVuWigbXUPfh0V47WsSG4hGeU71AQfY4BGDcF1OmwUJWqrV63Ut1611asoU1lvTp3_LFgvO7B_mV-fGbjaAZDPHB0EFY2D3oB1AUxS1rt_F3wBuluOjw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2369405590</pqid></control><display><type>article</type><title>Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Lehto, Joonas ; Gunn, Jarmo ; Björn, Rikhard ; Malmberg, Markus ; Airaksinen, K.E. Juhani ; Kytö, Ville ; Nieminen, Tuomo ; Hartikainen, Juha E.K. ; Biancari, Fausto ; Kiviniemi, Tuomas O.</creator><creatorcontrib>Lehto, Joonas ; Gunn, Jarmo ; Björn, Rikhard ; Malmberg, Markus ; Airaksinen, K.E. Juhani ; Kytö, Ville ; Nieminen, Tuomo ; Hartikainen, Juha E.K. ; Biancari, Fausto ; Kiviniemi, Tuomas O.</creatorcontrib><description>Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive interventions are scarce. We sought to assess the occurrence of mortality, new-onset atrial fibrillation (AF), cerebrovascular events, and major bleeds in PPS patients requiring medical attention in a combination database of 671 patients who underwent isolated surgical aortic valve replacement with a bioprosthesis (n = 361) or mechanical prosthesis (n = 310) between 2002 and 2014 (Cardiovascular Research Consortium—A Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients [CAREBANK] 2016-2018). PPS was defined as moderate if it resulted in delayed hospital discharge, readmission, or medical therapy because of the symptoms; and severe if it required interventions for the evacuation of pleural or pericardial effusion. The overall incidence of PPS was 11.2%. Median time to diagnosis was 16 (interquartile range, 11-36) days. Severe PPS was diagnosed in 3.6% of patients. Severe PPS seemed to be associated with higher mortality (hazard ratio, 2.01; 95% confidence interval, 1.03-3.91; P = .040). Moderate or severe PPS increased the risk of new-onset AF during the early postoperative period (hazard ratio, 1.72; 95% confidence interval, 1.12-2.63; P = .012). No significant associations were found between PPS and cerebrovascular events or major bleeds during the follow-up. Patients with PPS requiring invasive interventions are at increased risk for mortality unlike those with mild to moderate forms of the disease. PPS requiring medical attention is associated with a higher AF rate during the early postoperative period but has no significant effect on the occurrence of major stroke, stroke or transient ischemic attack, or major bleeds during long-term follow-up. Patients with severe PPS were at increased risk for mortality. A transient increased risk of new-onset AF was observed, but PPS had no effect on the occurrence of cerebrovascular events or major bleeds. [Display omitted]</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2019.12.114</identifier><identifier>PMID: 32107032</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>adverse events ; Aged ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Cardiac Surgical Procedures - adverse effects ; Female ; Finland - epidemiology ; Follow-Up Studies ; Forecasting ; Heart Valve Diseases - surgery ; Humans ; Incidence ; Male ; Middle Aged ; mortality ; pericardium ; Postoperative Complications ; postpericardiotomy syndrome ; Postpericardiotomy Syndrome - diagnosis ; Postpericardiotomy Syndrome - epidemiology ; Prospective Studies ; Risk Factors ; Survival Rate - trends ; thoracic surgery</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2020-12, Vol.160 (6), p.1446-1456</ispartof><rights>2020 The Author(s)</rights><rights>Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-d4e18e13de44921e2adb8d53c610a78295595f74999a9550e65f9b0de35c95613</citedby><cites>FETCH-LOGICAL-c404t-d4e18e13de44921e2adb8d53c610a78295595f74999a9550e65f9b0de35c95613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2019.12.114$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32107032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lehto, Joonas</creatorcontrib><creatorcontrib>Gunn, Jarmo</creatorcontrib><creatorcontrib>Björn, Rikhard</creatorcontrib><creatorcontrib>Malmberg, Markus</creatorcontrib><creatorcontrib>Airaksinen, K.E. Juhani</creatorcontrib><creatorcontrib>Kytö, Ville</creatorcontrib><creatorcontrib>Nieminen, Tuomo</creatorcontrib><creatorcontrib>Hartikainen, Juha E.K.</creatorcontrib><creatorcontrib>Biancari, Fausto</creatorcontrib><creatorcontrib>Kiviniemi, Tuomas O.</creatorcontrib><title>Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive interventions are scarce. We sought to assess the occurrence of mortality, new-onset atrial fibrillation (AF), cerebrovascular events, and major bleeds in PPS patients requiring medical attention in a combination database of 671 patients who underwent isolated surgical aortic valve replacement with a bioprosthesis (n = 361) or mechanical prosthesis (n = 310) between 2002 and 2014 (Cardiovascular Research Consortium—A Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients [CAREBANK] 2016-2018). PPS was defined as moderate if it resulted in delayed hospital discharge, readmission, or medical therapy because of the symptoms; and severe if it required interventions for the evacuation of pleural or pericardial effusion. The overall incidence of PPS was 11.2%. Median time to diagnosis was 16 (interquartile range, 11-36) days. Severe PPS was diagnosed in 3.6% of patients. Severe PPS seemed to be associated with higher mortality (hazard ratio, 2.01; 95% confidence interval, 1.03-3.91; P = .040). Moderate or severe PPS increased the risk of new-onset AF during the early postoperative period (hazard ratio, 1.72; 95% confidence interval, 1.12-2.63; P = .012). No significant associations were found between PPS and cerebrovascular events or major bleeds during the follow-up. Patients with PPS requiring invasive interventions are at increased risk for mortality unlike those with mild to moderate forms of the disease. PPS requiring medical attention is associated with a higher AF rate during the early postoperative period but has no significant effect on the occurrence of major stroke, stroke or transient ischemic attack, or major bleeds during long-term follow-up. Patients with severe PPS were at increased risk for mortality. A transient increased risk of new-onset AF was observed, but PPS had no effect on the occurrence of cerebrovascular events or major bleeds. [Display omitted]</description><subject>adverse events</subject><subject>Aged</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Heart Valve Diseases - surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>pericardium</subject><subject>Postoperative Complications</subject><subject>postpericardiotomy syndrome</subject><subject>Postpericardiotomy Syndrome - diagnosis</subject><subject>Postpericardiotomy Syndrome - epidemiology</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Survival Rate - trends</subject><subject>thoracic surgery</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKAzEUhoMotl6eQJAs3cyYy2TaLFyIeIOCGwV3IU3OaMrMZEzSkb69qVWXrnIg3_8fzofQGSUlJbS-XJWrZMZYMkJlSVlJabWHppTIWVHPxes-mhLCWCEY4xN0FOOKEDLL7CGacEbzyNkU2Ws7QoiAYYQ-Rax7i-M6jG7ULf506R0PPqYBgjM6WOeT7zY4bnobfAdYNwnCln_L3y3WPiRncI6OgAMMrTbQ5doTdNDoNsLpz3uMXu5un28eisXT_ePN9aIwFalSYSugc6DcQlVJRoFpu5xbwU1NiZ7NmRRCimZWSSl1ngnUopFLYoELI0VN-TG62PUOwX-sISbVuWigbXUPfh0V47WsSG4hGeU71AQfY4BGDcF1OmwUJWqrV63Ut1611asoU1lvTp3_LFgvO7B_mV-fGbjaAZDPHB0EFY2D3oB1AUxS1rt_F3wBuluOjw</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Lehto, Joonas</creator><creator>Gunn, Jarmo</creator><creator>Björn, Rikhard</creator><creator>Malmberg, Markus</creator><creator>Airaksinen, K.E. Juhani</creator><creator>Kytö, Ville</creator><creator>Nieminen, Tuomo</creator><creator>Hartikainen, Juha E.K.</creator><creator>Biancari, Fausto</creator><creator>Kiviniemi, Tuomas O.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202012</creationdate><title>Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement</title><author>Lehto, Joonas ; Gunn, Jarmo ; Björn, Rikhard ; Malmberg, Markus ; Airaksinen, K.E. Juhani ; Kytö, Ville ; Nieminen, Tuomo ; Hartikainen, Juha E.K. ; Biancari, Fausto ; Kiviniemi, Tuomas O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-d4e18e13de44921e2adb8d53c610a78295595f74999a9550e65f9b0de35c95613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>adverse events</topic><topic>Aged</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Female</topic><topic>Finland - epidemiology</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Heart Valve Diseases - surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>pericardium</topic><topic>Postoperative Complications</topic><topic>postpericardiotomy syndrome</topic><topic>Postpericardiotomy Syndrome - diagnosis</topic><topic>Postpericardiotomy Syndrome - epidemiology</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>thoracic surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lehto, Joonas</creatorcontrib><creatorcontrib>Gunn, Jarmo</creatorcontrib><creatorcontrib>Björn, Rikhard</creatorcontrib><creatorcontrib>Malmberg, Markus</creatorcontrib><creatorcontrib>Airaksinen, K.E. Juhani</creatorcontrib><creatorcontrib>Kytö, Ville</creatorcontrib><creatorcontrib>Nieminen, Tuomo</creatorcontrib><creatorcontrib>Hartikainen, Juha E.K.</creatorcontrib><creatorcontrib>Biancari, Fausto</creatorcontrib><creatorcontrib>Kiviniemi, Tuomas O.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lehto, Joonas</au><au>Gunn, Jarmo</au><au>Björn, Rikhard</au><au>Malmberg, Markus</au><au>Airaksinen, K.E. Juhani</au><au>Kytö, Ville</au><au>Nieminen, Tuomo</au><au>Hartikainen, Juha E.K.</au><au>Biancari, Fausto</au><au>Kiviniemi, Tuomas O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2020-12</date><risdate>2020</risdate><volume>160</volume><issue>6</issue><spage>1446</spage><epage>1456</epage><pages>1446-1456</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive interventions are scarce. We sought to assess the occurrence of mortality, new-onset atrial fibrillation (AF), cerebrovascular events, and major bleeds in PPS patients requiring medical attention in a combination database of 671 patients who underwent isolated surgical aortic valve replacement with a bioprosthesis (n = 361) or mechanical prosthesis (n = 310) between 2002 and 2014 (Cardiovascular Research Consortium—A Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients [CAREBANK] 2016-2018). PPS was defined as moderate if it resulted in delayed hospital discharge, readmission, or medical therapy because of the symptoms; and severe if it required interventions for the evacuation of pleural or pericardial effusion. The overall incidence of PPS was 11.2%. Median time to diagnosis was 16 (interquartile range, 11-36) days. Severe PPS was diagnosed in 3.6% of patients. Severe PPS seemed to be associated with higher mortality (hazard ratio, 2.01; 95% confidence interval, 1.03-3.91; P = .040). Moderate or severe PPS increased the risk of new-onset AF during the early postoperative period (hazard ratio, 1.72; 95% confidence interval, 1.12-2.63; P = .012). No significant associations were found between PPS and cerebrovascular events or major bleeds during the follow-up. Patients with PPS requiring invasive interventions are at increased risk for mortality unlike those with mild to moderate forms of the disease. PPS requiring medical attention is associated with a higher AF rate during the early postoperative period but has no significant effect on the occurrence of major stroke, stroke or transient ischemic attack, or major bleeds during long-term follow-up. Patients with severe PPS were at increased risk for mortality. A transient increased risk of new-onset AF was observed, but PPS had no effect on the occurrence of cerebrovascular events or major bleeds. [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32107032</pmid><doi>10.1016/j.jtcvs.2019.12.114</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-5223
ispartof The Journal of thoracic and cardiovascular surgery, 2020-12, Vol.160 (6), p.1446-1456
issn 0022-5223
1097-685X
language eng
recordid cdi_proquest_miscellaneous_2369405590
source MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals
subjects adverse events
Aged
Aortic Valve - diagnostic imaging
Aortic Valve - surgery
Cardiac Surgical Procedures - adverse effects
Female
Finland - epidemiology
Follow-Up Studies
Forecasting
Heart Valve Diseases - surgery
Humans
Incidence
Male
Middle Aged
mortality
pericardium
Postoperative Complications
postpericardiotomy syndrome
Postpericardiotomy Syndrome - diagnosis
Postpericardiotomy Syndrome - epidemiology
Prospective Studies
Risk Factors
Survival Rate - trends
thoracic surgery
title Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T00%3A56%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Adverse%20events%20and%20survival%20with%20postpericardiotomy%20syndrome%20after%20surgical%20aortic%20valve%20replacement&rft.jtitle=The%20Journal%20of%20thoracic%20and%20cardiovascular%20surgery&rft.au=Lehto,%20Joonas&rft.date=2020-12&rft.volume=160&rft.issue=6&rft.spage=1446&rft.epage=1456&rft.pages=1446-1456&rft.issn=0022-5223&rft.eissn=1097-685X&rft_id=info:doi/10.1016/j.jtcvs.2019.12.114&rft_dat=%3Cproquest_cross%3E2369405590%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2369405590&rft_id=info:pmid/32107032&rft_els_id=S0022522320302312&rfr_iscdi=true