Chronic Postpericardiotomy Syndrome and Cardiac Tamponade Lasting for Two Years after Open Heart Surgery

Postpericardiotomy syndrome (PPS) is a major cause of morbidity after cardiac surgery and may cause bypass graft closure and fatal cardiac tamponade. Treatment modalities include nonsteroidal antiinflammatory drugs, corticosteroids, diuresis, drainage, and pericardiectomy in severe cases. Usually the syndrome lasts weeks only, and persistence beyond six months is exceptional. We describe a 64-year-old male patient of chronic PPS, with persistent pericardial effusions and tamponade lasting for two years after an initial open heart surgery. The patient was treated successfully with thoracoscopic partial pericardiectomy and low-dose maintenance steroids and colchicine for two months.