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The effect of short-term prophylactic acetylsalicylic acid on the incidence of postpericardiotomy syndrome after surgical closure of atrial septal defects.

Abstract
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.
AuthorsPeter J Gill, Karen Forbes, James Y Coe
JournalPediatric cardiology (Pediatr Cardiol) Vol. 30 Issue 8 Pg. 1061-7 (Nov 2009) ISSN: 1432-1971 [Electronic] United States
PMID19636482 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin
Topics
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Aspirin (therapeutic use)
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Heart Septal Defects, Atrial (surgery)
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Pericardiectomy (adverse effects)
  • Postoperative Care
  • Postpericardiotomy Syndrome (drug therapy, etiology, prevention & control)
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

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