Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Effect of Postoperative Constrictive Physiology on Early Outcomes after Off-Pump Coronary Artery Bypass Grafting

  • Kim, Jung-Hwan (Division of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Hwang, Yoo-Hwa (Division of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Youn, Young-Nam (Division of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Yoo, Kyung-Jong (Division of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine)
  • Received : 2012.08.10
  • Accepted : 2012.10.09
  • Published : 2013.02.05
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Abstract

Background: Constrictive pericarditis after coronary artery bypass surgery has been known to affect cardiac output by limiting diastolic ventricular filling. We aimed to assess the influence of postoperative constrictive physiology on the early outcomes of patients undergoing off-pump coronary artery bypass grafting (OPCAB). Materials and Methods: Between January 2008 and July 2011, 903 patients underwent an isolated OPCAB and postoperative transthoracic-echocardiography. The patient cohort was classified into two groups: group A, constrictive physiology and group B, control group without constrictive physiology. Early outcomes were analyzed between the two groups. Results: Of the total 903 patients, group A consisted of 153 patients (16.9%). The amount of blood loss in group A during the postoperative 24 hours was greater than that of group B, but this was not statistically significant (p=0.20). No significant differences were found in the mortality rates (group A, 0.6%; group B, 1.4%; p=0.40) and 30-day major adverse cardiac and cerebrovascular events (MACCEs; group A, 3.3%; group B, 6.1%; p=0.42). Conclusion: Postoperative constrictive physiology does not affect 30-day MACCEs or other major complications after OPCAB. The results of this study suggest that patients with early postoperative constrictive physiology do not need medical or surgical treatment, and that conservative care is sufficient.

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References

  1. Song JM. Constrictive pericarditis. Curr Pract Cardiol 2010; 4:24-32.
  2. Talreja DR, Edwards WD, Danielson GK, et al. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation 2003;108:1852-7. https://doi.org/10.1161/01.CIR.0000087606.18453.FD
  3. Haley JH, Tajik AJ, Danielson GK, Schaff HV, Mulvagh SL, Oh JK. Transient constrictive pericarditis: causes and natural history. J Am Coll Cardiol 2004;43:271-5. https://doi.org/10.1016/j.jacc.2003.08.032
  4. Sagrista-Sauleda J, Permanyer-Miralda G, Candell-Riera J, Angel J, Soler-Soler J. Transient cardiac constriction: an unrecognized pattern of evolution in effusive acute idiopathic pericarditis. Am J Cardiol 1987;59:961-6. https://doi.org/10.1016/0002-9149(87)91134-9
  5. Heidecker J, Sahn SA. The spectrum of pleural effusions after coronary artery bypass grafting surgery. Clin Chest Med 2006;27:267-83. https://doi.org/10.1016/j.ccm.2006.01.007
  6. Matsuyama K, Matsumoto M, Sugita T, et al. Clinical characteristics of patients with constrictive pericarditis after coronary bypass surgery. Jpn Circ J 2001;65:480-2. https://doi.org/10.1253/jcj.65.480
  7. Anderson CA, Rodriguez E, Shammas RL, Kypson AP. Early constrictive epicarditis after coronary artery bypass surgery. Ann Thorac Surg 2009;87:642-3. https://doi.org/10.1016/j.athoracsur.2008.07.028
  8. Raheb JG, Tripp HF. Constrictive pericarditis after bypass leading to internal mammary graft failure. Ann Thorac Surg 2000;69:951-3. https://doi.org/10.1016/S0003-4975(99)01412-5
  9. Fowler NO. Constrictive pericarditis: its history and current status. Clin Cardiol 1995;18:341-50. https://doi.org/10.1002/clc.4960180610
  10. Effler DB. Chronic constrictive pericarditis treated with pericardiectomy. Am J Cardiol 1961;7:62-8. https://doi.org/10.1016/0002-9149(61)90423-4
  11. Cohen MV, Greenberg MA. Constrictive pericarditis: early and late complication of cardiac surgery. Am J Cardiol 1979;43:657-61. https://doi.org/10.1016/0002-9149(79)90028-6
  12. Kigawa I, Miura S, Fukuda S, Miyairi T. Constrictive pericarditis after minimally invasive coronary artery bypass grafting: report of a case. Kyobu Geka 2009;62:1175-7.
  13. Elena AA. Pericardial effusion after cardiac surgery: risk factors, patient profiles, and contemporary management. Ann Thorac Surg 2010;89:112-8. https://doi.org/10.1016/j.athoracsur.2009.09.026

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