Pericardial drainage: subxiphoid vs. transthoracic approach. Kim BJ, Ma JS. Hajduczok ZD, Ferguson DW. Pericardial effusion and tamponade. The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the contributions of previous authors Kelly S Skoumal, DO, MS, FAAP; John W Graneto, DO, FACEP, FAAP; and David A Lewis, MD, FAAP, FACC, to the original writing and development of this article.



This is a less invasive procedure in which a pericardial window is created in the catheterization laboratory using a balloon catheter under fluoroscopic guidance.Currently, there is no known preventative therapy available for postpericardiotomy syndrome.A randomized controlled trial evaluating the use of colchicine to prevent postpericardiotomy syndrome (PPS) in patients undergoing cardiopulmonary bypass did not find a statistically significant difference from placebo.Preliminary findings from the Colchicine for Prevention of the Postpericardiotomy Syndrome and Postoperative Atrial Fibrillation (COPPS) trial in adults indicated that compared with placebo, perioperative use of colchicine reduced the incidence of PPS but not of postoperative atrial fibrillation or postoperative pericardial/pleural effusion.In a systematic review of the literature for prophylaxis and treatment of PPS, Cantinotti et al found three major medication classes were used: nonsteroidal anti-inflammatory agents (NSAIDs), and colchicine.Andreev DA, Giliarov MIu, Syrkin AL, Udovichenko AE, Gerok DV. Lehto J, Virolainen J. Postpericardiotomy syndrome. Controversial issues in the management of pericardial diseases. Cabalka AK, Rosenblatt HM, Towbin JA, et al.

Little AG, Kremser PC, Wade JL, Levett JM, DeMeester TR, Skinner DB. Wessman DE, Stafford CM. Finkelstein Y, Shemesh J, Mahlab K, et al. Meta-analysis of randomized trials focusing on prevention of the postpericardiotomy syndrome. Pericardial disease: diagnosis and management. Journal Article Guidelines on the diagnosis and management of pericardial diseases executive summary. Panel B is a delayed enhancement image obtained after injection of gadolinium. Snyder MJ, Bepko J, White M. Acute pericarditis: diagnosis and management.

Rationale and design of the COPPS trial: a randomised, placebo-controlled, multicentre study on the use of colchicine for the primary prevention of postpericardiotomy syndrome. The postcardiac injury syndrome: case report and review of the literature. [1, 2, 3, 4] It is more common in patients who have undergone surgery that involves opening the pericardium (in the United States, the estimated frequency varies from 2% to 30% of these patients). Prominent visceral pericardium is seen (large white arrow) and is surrounded by a small pericardial effusion. All rights reserved. Recurrent pericardial effusion after nonpenetrating chest trauma: report of two cases treated with adrenocortical steroids. A randomized placebo-controlled trial. Postpericardiotomy syndrome (PPS) is a febrile illness secondary to an inflammatory reaction involving the pleura and pericardium. Forbes TJ, Horenstein MS, Vincent JA. A randomized placebo-controlled trial. Repeated postpericardiotomy syndrome following a temporary transvenous pacemaker insertion, a permanent transvenous pacemaker insertion and surgical pericardiotomy.

Unusual complications of epicardial pacemakers. The significance of anticardiolipin antibodies and anti-heart muscle antibodies for the diagnosis of postpericardiotomy syndrome. Colchicine for the prevention of postpericardiotomy syndrome. Goodkind MJ, Bloomer WE, Goodyer AV. This anti-inflammatory medication might be used, along with over-the-counter medications, to treat Dressler's syndrome. Imazio M, Brucato A, Markel G, et al. News Bed rest alone may be adequate to treat mild cases.

Cardiac tamponade complicating postpericardiotomy syndrome. The cardiovascular effects of colchicine: a comprehensive review. Imazio M, Brucato A, Rovere ME, et al. There is a need for the identification of biomarkers that will allow targeted treatment of patients who are at high risk for developing PPS during the postoperative period.© 2020 American College of Cardiology Foundation.

Timely treatment with colchicine in combination with NSAIDS may be useful in treating PPS. Seferovic PM, Ristic AD, Maksimovic R, et al. van Osch D, Nathoe HM, Jacob KA, et al.

Postpericardiotomy syndrome (PPS) occurs in about 15-30% of patients undergoing cardiac surgery (1-6, 7). /viewarticle/915680

Goutal H, Baur F, Bonnevie L, Monnier G, Le Blainvaux M, Brion R. Postpericardiotomy syndrome; a rare complication of transcavitary cardiac pacing: apropos of a case.

J Thorac Cardiovasc Surg.


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