Outcomes of the pediatric patients undergoing pericardiocentesis for cardiac surgery-related massive pericardial effusion

Aims: In this study, we aimed to evaluate the demographic and clinical characteristics of the patients who have moderate or severe cardiac surgery related pericardial effusion and relieved by pericardiocentesis. Methods: Twenty-one children (0-18 years of age) were identified retrospectively in a 10-year period (2010-2020) and we reviewed our medical records for demographic and clinical characteristics, management strategies and outcome of the patients. Results: Twenty-one patients were identified with a male to female ratio of 1.1. Mean age and body weight of the patients were 79.7 ± 56.6 months and 19.5 ± 14 kg respectively. Of the patients (33%) had at least one complaint, most common being dyspnea (19%) and fatigue (8.5%). The mean period between heart surgery and pericardiocentesis was 30.1±13.4 days. The distribution of surgical indications was as follows; atrial septal defect (42.8%), ventricular septal defect (23.8%), endocardial cushion defect (9.5%). The mean largest diameter of effusion and amount of fluid drained were 34.9 ± 13.4 mm and 349.3 ± 276.1 ml respectively. Macroscopic appearance of the fluid was serous in 28.5%, hemorrhagic in 66.7% and chylous in 4.8% patient. Of the 21 patients 13 were treated with anti-inflammatory drugs; NSAID (14.8%), NSAID and colcihicine (33.3%) NSAID, colchicine and coticosteroid (14.8%). On the follow up 2 (9.5%) patient died because of sepsis and heart failure. There were no procedure related complication, chronic effusion or constriction on the follow up. Conclusion: In conclusion, PPS is an important clinical syndrome that can lead to serious consequences. Therefore, patients at risk should be identified in the postoperative period and a patient-specific follow-up plan should be made. In the presence of tamponade or serious effusion, pericardiocentesis is a safe, effective and life-saving procedure in patients unresponsive to medical treatment along with anti-inflammatory drugs.