The effect of short-term prophylactic acetylsalicylic acid on the incidence of postpericardiotomy syndrome after surgical closure of atrial septal defects.
Postpericardiotomy syndrome (PPS), a potential complication of open heart surgery, has a variable clinical course and severity. This study evaluated the effectiveness of acetylsalicylic acid (ASA) prophylaxis in preventing PPS after surgical closure of atrial septal defects (ASDs) in pediatric patients. A retrospective review was performed for 177 patients who underwent uncomplicated ASD closure from 1986 to 2006. The study group received prophylactic ASA 20 to 50 mg/kg/day for 1 to 6 weeks after surgery, whereas the control group did not. The primary outcome was a diagnosis of PPS based on the presence of two or more of the following symptoms or signs occurring at least 72 h postoperatively: fever (temperature >38 degrees C), pericardial or pleural rub, and worsening or recurring anterior pleuritic chest pain. Consequently, PPS developed in 5 (2.8%) of the 177 children: 2.8% (3/106) in the control group and 2.8% (2/71) in the study group (p = 1.00). The secondary outcomes were frequency of other postoperative complications. Postoperative pericardial effusions experienced by 26.7% of the patients were identified more frequently in the treatment group (p < 0.001). Postoperative prophylaxis ASA at a dose of 20 to 50 mg/kg/day for 1 to 6 weeks after surgical closure of ASD does not decrease the incidence of PPS in pediatric patients.
Gill
Peter J
PJ
Division of Pediatric Cardiology, Department of Pediatrics, 4C2 Walter C Mackenzie Health Sciences Centre, University of Alberta, Edmonton, AB T6G 2R7, Canada. pjgill@ualberta.ca
Forbes
Karen
K
Coe
James Y
JY
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010492:Pericardiectomy / Q000009:adverse effects; D011182:Postoperative Care; D011185:Postpericardiotomy Syndrome / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin