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
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