Title: Prevention of Postoperative Pericarditis After Robotic Mitral Valve Surgery

Introduction: Pericarditis is a common occurrence after cardiac surgery, with an incidence of approximately 20-30%, including in our cohort of patients undergoing robotic mitral valve surgery (RMVS). Management aims to suppress inflammation and reduce the risk of recurrence through the use of anti-inflammatory medications such as colchicine, steroids, and NSAIDs. A strategy to routinely prevent the development of pericarditis after cardiac surgery, however, has yet to be definitively identified.

Purpose: To evaluate the effectiveness of a novel anti-inflammatory protocol in the prevention of postoperative pericarditis after robotic mitral valve surgery.

Methods:
•The “conventional” protocol for postoperative pericarditis prophylaxis at our institution includes a 6-day pre-packaged, tapered oral course of methylprednisolone (MP), followed by 4 mg/day of oral MP for an additional 10 days.
•The “novel” protocol includes the “conventional” protocol, with the addition of colchicine 0.3 mg twice a day (BID) for a duration of 30 days (Figure 1).

Results:
•48.3% (42/87) of patients comprised the “conventional” population, and 51.7% (45/87) comprised the “novel” population.
•Both populations had similar demographics, comorbidities, and intraoperative characteristics, including concomitant procedures (Table 1).
•23.0% (20/87) of the total cohort developed pericarditis after RMVS (Table 2).
•On multivariable regression analysis, the novel protocol was found to reduce the odds of pericarditis by 73%.

Conclusions: An anti-inflammatory protocol of oral methylprednisolone with a 30-day course of oral colchicine seems to decrease the incidence of postoperative pericarditis after robotic mitral valve surgery.