Is possible to prevent the Post-Pericardiotomy Syndrome?

The post-pericardiotomy syndrome (PPS) is not uncommon following cardiac surgery and may be a cause of severe complications (cardiac tamponade, large pleural effusion), hospital stay prolongation, and readmissions. The estimated incidence of the syndrome has a relatively wide range affecting from 10 to 40% of patients, depending on the adopted diagnostic criteria, institution, and type of cardiac surgery. On this basis, there is a need for standardized criteria for epidemiological and clinical purposes. These criteria should be adopted in future clinical trials and studies on the PPS as well. Such criteria should include both clinical and instrumental findings considering the spectrum of pleuropericardial involvement of the syndrome. In any case, pharmacologic preventive strategies are worthy of further investigation. At present, data from 2 RCTs enrolling a total of 471 patients, have shown that colchicine was associated with a reduced risk of PPS (OR = 0.38 95% CI 0.22 to 0.65). Available evidence suggests that colchicine 0.5-1.0 mg/day is effective for reducing recurrences of pericarditis and at the same doses is efficacious to prevent the PPS.