Predictors of pericardial effusion after orthotopic heart transplantation

Jacquelyn A. Quin, M. Peter Tauriainen, Lynne M. Huber, Donald D McIntire, Patricia A. Kaiser, W Steves Ring, Michael E Jessen

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives: Pericardial effusion occurs frequently after orthotopic heart transplantation, but the causes of this complication have not been well described. This study was designed to identify factors predisposing toward the development of significant postoperative pericardial effusions in a large, single-institution population of orthotopic heart transplant recipients. Methods: A retrospective review of more than 90 preoperative, intraoperative, and postoperative variables was conducted for 241 patients undergoing orthotopic heart transplantation from September 1988 to December 1999. Patients who had significant postoperative pericardial effusions develop were identified from postoperative echocardiograms by standard criteria. Factors associated with the development of significant pericardial effusions were determined by multivariate logistic regression analysis. Results: Echocardiographic data were available for 203 of 241 transplant recipients. Forty-two patients (21%) had significant effusions develop. According to multivariate analysis, pericardial effusions were less likely to occur in recipients with a history of previous cardiac surgery (odds ratio 0.13, 95% confidence interval 0.05-0.36, P < .0001) and with greater weight (odds ratio 0.96, 95% confidence interval 0.94-0.99, P < .0048). Pericardial effusions were more likely to occur in patients who had received aminocaproic acid during the operation (odds ratio 5.92, 95% confidence interval 2.23-15.72, P < .0008). Patient survival and hospital length of stay did not differ between patients with and without postoperative pericardial effusions. Conclusions: Postoperative pericardial effusions develop in approximately 20% of patients undergoing orthotopic cardiac transplantation. On the basis of the risk factors identified in this study, prevention may prove difficult, although avoidance of the intraoperative use of aminocaproic acid may be helpful.

Original languageEnglish (US)
Pages (from-to)979-983
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume124
Issue number5
DOIs
StatePublished - Nov 1 2002

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Pericardial Effusion
Heart Transplantation
Aminocaproic Acid
Odds Ratio
Confidence Intervals
Length of Stay
Causality
Thoracic Surgery
Multivariate Analysis
Logistic Models
Regression Analysis
Weights and Measures
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Predictors of pericardial effusion after orthotopic heart transplantation. / Quin, Jacquelyn A.; Tauriainen, M. Peter; Huber, Lynne M.; McIntire, Donald D; Kaiser, Patricia A.; Ring, W Steves; Jessen, Michael E.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 124, No. 5, 01.11.2002, p. 979-983.

Research output: Contribution to journalArticle

Quin, Jacquelyn A. ; Tauriainen, M. Peter ; Huber, Lynne M. ; McIntire, Donald D ; Kaiser, Patricia A. ; Ring, W Steves ; Jessen, Michael E. / Predictors of pericardial effusion after orthotopic heart transplantation. In: Journal of Thoracic and Cardiovascular Surgery. 2002 ; Vol. 124, No. 5. pp. 979-983.
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abstract = "Objectives: Pericardial effusion occurs frequently after orthotopic heart transplantation, but the causes of this complication have not been well described. This study was designed to identify factors predisposing toward the development of significant postoperative pericardial effusions in a large, single-institution population of orthotopic heart transplant recipients. Methods: A retrospective review of more than 90 preoperative, intraoperative, and postoperative variables was conducted for 241 patients undergoing orthotopic heart transplantation from September 1988 to December 1999. Patients who had significant postoperative pericardial effusions develop were identified from postoperative echocardiograms by standard criteria. Factors associated with the development of significant pericardial effusions were determined by multivariate logistic regression analysis. Results: Echocardiographic data were available for 203 of 241 transplant recipients. Forty-two patients (21{\%}) had significant effusions develop. According to multivariate analysis, pericardial effusions were less likely to occur in recipients with a history of previous cardiac surgery (odds ratio 0.13, 95{\%} confidence interval 0.05-0.36, P < .0001) and with greater weight (odds ratio 0.96, 95{\%} confidence interval 0.94-0.99, P < .0048). Pericardial effusions were more likely to occur in patients who had received aminocaproic acid during the operation (odds ratio 5.92, 95{\%} confidence interval 2.23-15.72, P < .0008). Patient survival and hospital length of stay did not differ between patients with and without postoperative pericardial effusions. Conclusions: Postoperative pericardial effusions develop in approximately 20{\%} of patients undergoing orthotopic cardiac transplantation. On the basis of the risk factors identified in this study, prevention may prove difficult, although avoidance of the intraoperative use of aminocaproic acid may be helpful.",
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AU - Kaiser, Patricia A.

AU - Ring, W Steves

AU - Jessen, Michael E

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N2 - Objectives: Pericardial effusion occurs frequently after orthotopic heart transplantation, but the causes of this complication have not been well described. This study was designed to identify factors predisposing toward the development of significant postoperative pericardial effusions in a large, single-institution population of orthotopic heart transplant recipients. Methods: A retrospective review of more than 90 preoperative, intraoperative, and postoperative variables was conducted for 241 patients undergoing orthotopic heart transplantation from September 1988 to December 1999. Patients who had significant postoperative pericardial effusions develop were identified from postoperative echocardiograms by standard criteria. Factors associated with the development of significant pericardial effusions were determined by multivariate logistic regression analysis. Results: Echocardiographic data were available for 203 of 241 transplant recipients. Forty-two patients (21%) had significant effusions develop. According to multivariate analysis, pericardial effusions were less likely to occur in recipients with a history of previous cardiac surgery (odds ratio 0.13, 95% confidence interval 0.05-0.36, P < .0001) and with greater weight (odds ratio 0.96, 95% confidence interval 0.94-0.99, P < .0048). Pericardial effusions were more likely to occur in patients who had received aminocaproic acid during the operation (odds ratio 5.92, 95% confidence interval 2.23-15.72, P < .0008). Patient survival and hospital length of stay did not differ between patients with and without postoperative pericardial effusions. Conclusions: Postoperative pericardial effusions develop in approximately 20% of patients undergoing orthotopic cardiac transplantation. On the basis of the risk factors identified in this study, prevention may prove difficult, although avoidance of the intraoperative use of aminocaproic acid may be helpful.

AB - Objectives: Pericardial effusion occurs frequently after orthotopic heart transplantation, but the causes of this complication have not been well described. This study was designed to identify factors predisposing toward the development of significant postoperative pericardial effusions in a large, single-institution population of orthotopic heart transplant recipients. Methods: A retrospective review of more than 90 preoperative, intraoperative, and postoperative variables was conducted for 241 patients undergoing orthotopic heart transplantation from September 1988 to December 1999. Patients who had significant postoperative pericardial effusions develop were identified from postoperative echocardiograms by standard criteria. Factors associated with the development of significant pericardial effusions were determined by multivariate logistic regression analysis. Results: Echocardiographic data were available for 203 of 241 transplant recipients. Forty-two patients (21%) had significant effusions develop. According to multivariate analysis, pericardial effusions were less likely to occur in recipients with a history of previous cardiac surgery (odds ratio 0.13, 95% confidence interval 0.05-0.36, P < .0001) and with greater weight (odds ratio 0.96, 95% confidence interval 0.94-0.99, P < .0048). Pericardial effusions were more likely to occur in patients who had received aminocaproic acid during the operation (odds ratio 5.92, 95% confidence interval 2.23-15.72, P < .0008). Patient survival and hospital length of stay did not differ between patients with and without postoperative pericardial effusions. Conclusions: Postoperative pericardial effusions develop in approximately 20% of patients undergoing orthotopic cardiac transplantation. On the basis of the risk factors identified in this study, prevention may prove difficult, although avoidance of the intraoperative use of aminocaproic acid may be helpful.

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