The Use of Posterior Pericardiotomy Technique to Prevent Postoperative Pericardial Effusion in Cardiac Surgery

Abstract

Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.

Systematic review and meta-analysis of randomized controlled trials assessing safety and efficacy of posterior pericardial drainage in patients undergoing heart surgery

“…Of those, 18 were further excluded because they were not pertinent to the design of the meta-analysis or did not meet the explicit inclusion criteria. Nineteen RCTs 11,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] that enrolled 3425 patients eventually were included in the analysis. Patients were divided into 2 groups: those with a posterior pericardial drainage (n ¼ 1723) and control group without (n ¼ 1702).…”

“…Patients were divided into 2 groups: those with a posterior pericardial drainage (n ¼ 1723) and control group without (n ¼ 1702). In the group of patients who received a posterior pericardial drainage, 1447 patients underwent PP 11,[19][20][21][22][23][24][25][26][28][29][30][33][34][35][36][37] ; in 103 patients, a chest tube was placed within the posterior pericardium 27,30 ; 173 patients received both PP and posterior pericardium chest tube. 31,32 On-pump coronary artery bypass grafting (CABG) was the most frequently performed cardiac procedure, 11,19,20,23,25,28,[30][31][32][33][34][35][36] followed by combined CABG and/or valve replacement.…”

“…31,32 On-pump coronary artery bypass grafting (CABG) was the most frequently performed cardiac procedure, 11,19,20,23,25,28,[30][31][32][33][34][35][36] followed by combined CABG and/or valve replacement. 21,22,24,37 Two studies reported on patients undergoing valve replacement and/or ascending aorta surgery 26,27 and another on patients who received offpump CABG alone. 29 Summaries of the studies, as well as patients' baseline characteristics, are reported in Table 1.…”

“…PP was performed as described by Mulay and colleagues 38 and comprised a longitudinal, 4-cm long incision parallel and posterior to the phrenic nerve, extending from left inferior pulmonary vein to the diaphragm in most cases. 11,[19][20][21][22][23][24][25][26][28][29][30][31][32]35,36 A detailed technique is reported in Table E5. Table E6 includes an analysis of potential sources of bias for randomized studies using the components recommended by the Cochrane Collaboration.…”

Efficacy of posterior pericardiotomy in prevention of atrial fibrillation and pericardial effusion after aortic valve replacement: a randomized controlled trial

“…Эффектив-ность в отношении ПОФП в данном исследовании не оценивалась [26]. Также проведены исследования со смешанным составом больных, которым выполнялись как коронарные шунтирования, так и вмешательства на клапанах сердца, однако авторов не интересова-ло влияние ЗП на послеоперационную фибрилляцию предсердий, а только на ПВ [27,28]. Некоторые иссле-дователи применяли модифицированную технику ЗП с удалением фрагмента перикарда («перикардиальное окно»).…”