Fechamento primário do pericárdio em cirurgia cardíaca: uma opção segura?

Abstract

Objectives: The primary closure of the pericardium may reduce the risk of cardiac injury during reoperation, especially the right ventricle, aorta and coronary bypass grafts. Nevertheless, concern about adverse hemodynamic effects prevents most heart surgeons of closing the pericardium.Methods: We evaluated 30 patients undergoing open heart surgery consecutively who had the pericardium primarily closed, named (group A) and 18 patients, as a control group (group B) in which the pericardium was left open. All patients underwent posteroanterior and lateral chest roentgenograms before surgery and one week postoperatively. Postoperative evaluation also included echocardiograms, ECG and postoperative enzyme analysis.Results: There were no deaths or any complications in none of the groups (acute myocardial infarction, stroke, bleeding or cardiac tamponate). We observed statistical differences between both groups especially in echocardiogram parameters and cardiothoracic ratio without clinical impact.Conclusion: The primary closure of the pericardium is a simple method to facilitate resternotomy during subsequent reoperative procedures. However, cardiac surgeons should be aware of the transient deterioration in hemodynamics associated with it, even thought there was no clinical significance in this study. Descriptors 366DANTAS, CEP ET AL -Pericardium closure after heart operations: a safe option? Bras Cir Cardiovasc 2010; 25(3): 365-370 Rev

A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press

“…Within this context, Dantas et al32 propose a simple method to facilitate resternotomy during subsequent re-operative procedures. Riedi et al33 determined the strength of respiratory muscle in cardiac surgery and its relationship with the postoperative pulmonary complications but found that preoperative respiratory strength couldn't be a predictor of postoperative pulmonary complication.…”

A Dedicated Stitch to Allow Early Safe Mobilization Avoiding Drain-Induced Heart Injury

“…Softer and more flexible drains could help to avoid those lesions. However, it does not solve the issue of contact between drain and heart chambers [4] .…”