Postpericardiotomy Syndrome after Nuss Procedure

Postpericardiotomy syndrome (PPS) was first described in 1953 in patients with fever and pleuritic chest pain undergoing rheumatic mitral stenosis repair surgery.1, 2 PPS was initially believed to be associated with rheumatic disease reactivation and was subsequently recognized as an autoimmune inflammatory process.1, 2 The proposed diagnostic criteria have changed over time1 but are currently based on the COPPS3 and COPPS-24 studies, which were developed to assess the benefit of colchicine in PPS.2 A PPS diagnosis requires at least two of the following criteria: fever of unknown cause, pain with characteristics of pleuritis or pericarditis, a rubbing sound on auscultation, and evidence of pericardial and/or pleural effusion with increased C-reactive protein level.3,-5 Most patients present a benign and self-limited progression.6 However, the form and severity of clinical presentation can vary widely from asymptomatic patients with mild pleural and/ or pericardial effusion to those with serious complications such as cardiac tamponade.1, 2