Campisano Martina, Celani Camilla, Franceschini Alessio, Pires Marafon Denise, Federici Silvia, Brancaccio Gianluca, Galletti Lorenzo, De Benedetti Fabrizio, Chinali Marcello, Insalaco Antonella
Division of Pediatric Cardiology, Bambino Gesù Children's Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
Division of Rheumatology, Bambino Gesù Children's Hospital, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
Front Pediatr. 2022 Aug 9;10:882118. doi: 10.3389/fped.2022.882118. eCollection 2022.
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.
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.
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%; < 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 ( < 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) (range 15.9-23.4, = 0.004).
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.
评估房间隔缺损（ASD）手术关闭后心包积液（PE）的发生率，并调查其发生的预测风险因素。
我们收集了2015年1月至2019年9月期间在罗马的 Bambino Gesù 儿童医院接受 ASD 修复心脏手术的203例患者的随访数据。
共纳入200/203例不同类型 ASD 患者。患者分为两组：第1组）38例（19%）发生 PE，第2组）162例（81%）未发生 PE。两组在手术时的性别或年龄方面无差异。术后48小时内发热在第1组比第2组更频繁（23.7%对2.5%；<0.0001）。出院时心电图显示发生 PE 的儿童有明显的 ST 段抬高，未发生 PE 的儿童为分别为24.3%和2.0%（<0.0001）。根据 PE 的严重程度，第1组患者分为两个亚组，即轻度 PE 患者31例（81.6%）和中度/重度 PE 患者7例（18.4%）。中度/重度 PE 患者的 BMI 值明显更高（中位数19.1 Kg/m²）（范围15.9 - 23.4，=0.004）。
术后发热和 ST 段抬高预示着随后会发生 PE，提示对这些患者类别进行更密切的随访。较高的 BMI 似乎与中度/重度 PE 的较高风险相关。
