The effect of posterior pericardiotomy after thoracic aortic surgery

Abstract

BackgroundPostoperative atrial fibrillation is a common complication of cardiovascular surgery. We aimed to examine the effectiveness of posterior pericardiotomy in reducing the incidence of postoperative atrial fibrillation after thoracic aortic surgery.MethodsThe study included 201 patients who underwent thoracic aortic open surgery between January 2014 and November 2021. We compared surgical outcomes between patients who underwent posterior pericardiotomy and those who did not. We also compared the preoperative characteristics and surgical outcomes between patients who showed postoperative atrial fibrillation and those who did not. Multivariate analysis was performed to determine the risk factors for postoperative atrial fibrillation.ResultsThe group that did not undergo posterior pericardiotomy had significantly longer mechanical ventilation duration than the group who did in the overall (p=0.005) and propensity-matched cohorts (p=0.001). The lengths of intensive care unit and hospital stays were significantly longer in the group that did not undergo posterior pericardiotomy than in the group that did in the overall and propensity-matched cohorts. Postoperative atrial fibrillation occurrence did not differ significantly between the two groups. Late pericardial tamponade occurred significantly more frequently in the group that did not undergo posterior pericardiotomy than in the group that did in the overall (p=0.03) and propensity-matched cohorts (p=0.03). Advanced age was independent predictors of postoperative atrial fibrillation. ConclusionsPosterior pericardiotomy has no effect on reducing postoperative atrial fibrillation after thoracic aortic surgery. Posterior pericardiotomy reduced the occurrence of late pericardial tamponade, length of ICU stay, length of hospital stay, and mechanical ventilation duration after surgery.