Postpericardiotomy syndrome.

Postpericardiotomy syndrome is an immune phenomenon that occurs from several days to months after surgical incision of the pericardium. Prominent clinical features include fever, pericarditis, and pleuritis. Of 161 patients with Wolff-Parkinson-White syndrome who underwent surgical treatment, 50 (31%) developed postpericardiotomy syndrome 4-12 days later. Of these 50 patients, 38 had sufficiently complete records for analysis. Significant radiographic abnormalities were present in 30 (79%) of these 38 patients, pericardial effusions in 19 (50%), pleural effusions in 26 (68%), and pulmonary infiltrates in four (10%). These radiographic signs almost always developed within 2 days of the onset of symptoms, either before or after, and were essentially absent in the 76 patients who did not clinically develop the syndrome. Postoperative radiographs can be extremely valuable in first suggesting or confirming the suspicion of postpericardiotomy syndrome.