title: Prolonged pericardial drainage using a soft drain reduces pericardial effusion and need for additional pericardial drainage following orthotopic heart transplantation.
abstract: OBJECTIVE
  Pericardial effusion can cause haemodynamic compromise after heart transplantation. We identified the effects of soft drains on the development of pericardial effusion.
  
  
  METHODS
  We enrolled 250 patients ≥17 years of age who underwent heart transplantation between July 1999 and April 2012 and received two conventional tubes (n = 96; 32 French), or two tubes with a soft drain (n = 154; 4.8 mm wide). The development of significant pericardial effusion or the need for drainage procedure during 1 month after heart transplantation was compared with the use of the propensity score matching method to adjust for selection bias.
  
  
  RESULTS
  At 1 month after transplantation, 69 patients (27.6%) developed significant pericardial effusion. Among these, 13 patients (5.2%) underwent pericardial drainage. According to multivariate analysis, history of previous cardiac surgery [odds ratio (OR) = 0.162; 95% confidence interval (CI) = 0.046-0.565; P = 0.004] and placement of a soft drain (OR = 0.186; 95% CI = 0.100-0.346; P < 0.001) were significant factors that prevented pericardial effusion or the need for drainage during the early postoperative period. For the 82 propensity score matched pairs, patients receiving an additional soft drain were at a lower risk of the development of significant pericardial effusion or the need for a pericardial drainage procedure during 1 month (OR = 0.148; 95% CI = 0.068-0.318; P < 0.001) compared with those receiving only two conventional tubes.
  
  
  CONCLUSIONS
  Pericardial soft drainage is a simple and safe procedure that reduces pericardial effusion and decreases the need for pericardial drainage after heart transplantation.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Yun Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea ctsjungsh@hanmail.net.
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Jung
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Won Chul
authors.initials: WC
authors.lastname: Cho
authors.affiliation: Division of Biostatistics, Center for Medical Research and Information, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Sung-Cheol
authors.initials: SC
authors.lastname: Yun
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jeong-Jun
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000328:Adult; D004322:Drainage / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000453:epidemiology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Heart transplantation; Pericardial effusion; Soft drain