Introduction & Objective: Complete drainage of fluid and blood from pericardial and pleural cavity
after cardiac surgery is very important because the residual blood, directly or indirectly, increases morbidity or
mortality. The main goal of this study was to find the best method of pericardial and pleural drainage after
cardiac surgery.
Materials & Methods: This study was performed in 415 patients undergoing open heart surgery in
Shariati Hospital between April 1998 and March 1999. Radiological findings and pericardial and pleural
effusion in terms of the drain sites and in terms of posterior pericardiotomy (groups A, B, C and D) were
analyzed and evaluated in these patients.
Results: In 21.7% of the patients on the 3rd postoperative day, and in 17.9% of the patients on the 7th
postoperative day, pleural effusion was seen. The lateral drain with or without posterior pericardiotomy
significantly reduced pleural effusion on the 3rd (p-value = 0.02) and 7th (p-value=0.0001) postoperative days
in comparison with the median drain. Pericardial effusion in this study was 32.2%, whereas the drain site did
not affect pericardial effusion, posterior pericardiotomy affected and reduced pericardial effusion. There was
significant difference (P-value = 0.0001) in terms of pericardial effusion between groups A, B, C and D.
Conclusions: This study shows the better outcome of posterior pericardiotomy and lateral (direct)
drainage of pleural cavity. In patients undergoing open heart surgery, if either of the pleural spaces is opened,
we recommend that a drain be directly inserted into that space laterally and that posterior pericardiotomy be
also performed for them.