Recurrent pericardial effusion after cardiac surgery: the use of colchicine after recalcitrant conventional therapy

Dainese, Luca; Cappai, Antioco; Biglioli, Paolo

doi:10.1186/1749-8090-6-96

Cited by 9 publications

(11 citation statements)

References 18 publications

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“…The latter comprising complete heart block, which occurred in a child with Down syndrome after AV canal repair. This is consistent with earlier observation that heart block can occur after cardiac surgery for some lesions including AV canal defect, TOF and VSD [21][22][23][24][25][26][27][28][29]. A plausible explanation is that these defects tend to be closely related to the conduction system, which easily gets damaged during cardiac surgery [21,26,29].…”

Section: Discussionsupporting

confidence: 90%

“…Its occurrence has been attributed to a number of factors including surgical and/or microvascular bleeding, epicardial tear with bleeding during pacing wire removal, postoperative anticoagulation, hypoalbuminemia and surgery-induced inflammatory reaction of the pericardium among others [24]. Complete resolution of the effusion following conventional treatment is the norm; but occasionally it may become persistent and/or recurrent, or even progressed to life-threatening cardiac tamponade, requiring invasive therapy [25].…”

Section: Discussionmentioning

confidence: 99%

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Pattern and Outcome of Cardiac Interventions Performed within and Outside Nigeria for Children with Structural Heart Diseases in Sokoto, North-western Nigeria

Sani

Waziri

et al. 2020

JSRR

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Background: Management of structural heart diseases is quite challenging in Nigeria, due to limited availability and access to cardiac care services. There is paucity of data on the pattern and outcome of cardiac interventions in children from the study area. Aims: To determine the pattern of cardiac interventions and the early outcome (within six-months) of such interventions in children with structural heart diseases (SHD) seen in our hospital. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, between August 2012 to September 2019. Methodology: All children with SHDs seen at our hospital, but had Cardiac surgery or interventional cardiac procedures within and outside Nigeria were recruited. Relevant information including type of lesion, procedure performed and the outcome within the first six months and length of hospital stay was analyzed. Results: Only 63 out of 780 (8.1%) children with structural heart diseases, aged 6 months-15 years (Mean age 6.5± 5.0 years, M: F = 1.3:1), had cardiac interventions. The interventions were surgical in 61 ((96.8%) and catheter-based in 2 (3.2%) patients; with 49 (77.8%) of these performed abroad. Patent Ductus arteriosus 14 (22.2%), Tetralogy of Fallot 14 (22.2%), ventricular septal defect 13 (20.6%) and atrial septal defect 6 (9.5%) were the commonest lesions for which interventions were undertaken. Early post-operative complications included pulmonary hypertensive crises, pericardial and pleural effusion, complete heart block and left branch pulmonary artery stenosis warranting re-intervention. During the first six months after the interventions, three (4.8%) patients died while 60 (95.2%) survivors were followed up. However, 25 (39.7%) of them were thereafter lost to follow. Conclusion: Majority of the cardiac interventions were surgical, performed predominantly in older children with CHDs; and associated with good outcome. However, most of them were undertaken outside the country, highlighting the need to ensure these services are available and accessible locally.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Pattern and Outcome of Cardiac Interventions Performed within and Outside Nigeria for Children with Structural Heart Diseases in Sokoto, North-western Nigeria

Sani

Waziri

et al. 2020

JSRR

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“…Colchicine is a tricyclic alkaloid agent, and its analgesic and anti-inflammatory effects have been linked to its ability to bind with tubulin, inhibiting neutrophil motility and activity, leading to a net anti-inflammatory effect. The essential antiinflammatory mechanism of colchicine is via the inhibition of granulocyte migration into the inflamed area, thereby inhibiting proliferation and affecting cells with high turnover (19).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sirolimus and Colchicine Treatment on the Development of Peritoneal Fibrozis in Rats Having Peritoneal Dialysis

Sagiroglu¹,

Sayhan²,

Yağcı³

et al. 2015

Balkan Med J

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“…Generally, several studies have indicated that oral aspirin is often selected as the initial treatment for postpericardiotomy syndrome, whereas additional steroids and colchicine are administered in refractory cases [2][3][4]. However, there is no consensus regarding the doses to be administered, administration methods, or durations.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Short-Term Oral Prednisolone Treatment in the Management of Pericardial Effusion Following Pediatric Cardiac Surgery

Mizumoto

Masaki

2021

Pediatr Cardiol

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A standard treatment for pericardial effusion without cardiac tamponade after pediatric cardiac surgery has not been established. We evaluated the efficacy of short-term oral prednisolone administration, which is the initial treatment for postoperative pericardial effusion without cardiac tamponade at our institution. Between October 2008 and March 2020, 1429 pediatric cardiac surgeries were performed at our institution. 91 patients required postoperative treatment for pericardial effusion. 81 were treated with short-term oral prednisolone. Pericardial effusion was evaluated using serial echocardiography during diastole. Pericardial drainage was performed for patients with circumferential pericardial effusion with a maximum diameter of ≥ 10 mm or signs of cardiac tamponade. Short-term oral prednisolone treatment was administered to patients with circumferential pericardial effusion with a maximum diameter of < 10 mm or localized pericardial effusion with a maximum diameter of ≥ 5 mm. Patients with localized pericardial effusion with a maximum diameter of < 5 mm were observed. Prednisolone (2 mg/kg/day) was administered orally for 3 days, added as needed. Short-term oral prednisolone treatment was effective in 71 cases and 90% of patients were regarded as responders. The remaining patients were deemed non-responders who required pericardial drainage. Overall, 55 responders were deemed early responders whose pericardial effusion disappeared within 3 days. There were no cases of deaths, infections, or recurrence of pericardial effusion. The amount of drainage fluid on the day of surgery was higher in the non-responders. In conclusion, short-term oral prednisolone treatment is effective and safe for treating pericardial effusion without cardiac tamponade after pediatric cardiac surgery.

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Recurrent pericardial effusion after cardiac surgery: the use of colchicine after recalcitrant conventional therapy

Cited by 9 publications

References 18 publications

Pattern and Outcome of Cardiac Interventions Performed within and Outside Nigeria for Children with Structural Heart Diseases in Sokoto, North-western Nigeria

Pattern and Outcome of Cardiac Interventions Performed within and Outside Nigeria for Children with Structural Heart Diseases in Sokoto, North-western Nigeria

Comparison of Sirolimus and Colchicine Treatment on the Development of Peritoneal Fibrozis in Rats Having Peritoneal Dialysis

Efficacy of Short-Term Oral Prednisolone Treatment in the Management of Pericardial Effusion Following Pediatric Cardiac Surgery

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