EFFECT OF ANTICOAGULANTS ON THE INCIDENCE OF LATE PERICARDIAL TAMPONADE FOLLOWING OPEN-HEART-SURGERY - THE HAWAII EXPERIENCE

We report on 17 cases of late pericardial tamponade (LPT, >60 hours po stoperatively) occurring post aortic and/or mitral valve replacement o r coronary artery bypass graft surgery between 1979 and 1994. This inc ludes one patient in whom LPT occurred twice. These cases were found f rom a search of 374 patients including those who were diagnosed with h emorrhagic complications secondary to open heart surgery, pericardial effusion and tamponade, those who underwent pericardiocentesis and a r andomly picked group of patients. The mean age of the group was 57.8 y ears and included 11 males and 6 females. Due to the relatively small size of our sample (reflecting the infrequency of this complication) w e force matched this tamponade group to look for any relationships tha t may exist between the incidence of LPT and anticoagulant therapy. No significant difference was found between the two groups with document ed preoperative anticoagulant therapy (number of days; p>0.2) or in re lation to coagulation tests (prothrombin time, partial thromboplastin time and platelet counts; p>0.2). In our case series, anticoagulant th erapy did not appear to significantly affect the incidence of LPT.