Posterior Pericardiotomy in 319 Cases of Coronary Artery Bypass Grafting

Sadeghpour Tabaee, A.; Mandeghar, M.H.; Vahedian, J.; Sadeghpour Tabaee, A.H.; Arefi, S.

Posterior Pericardiotomy in 319 Cases of Coronary Artery Bypass Grafting

Document Type : Original Article

Authors

A. Sadeghpour Tabaee ¹

M.H. Mandeghar ²

J. Vahedian ³

A.H. Sadeghpour Tabaee ⁴

S. Arefi ⁵

¹ Assistant Professor of Cardiac Surgery, Iran University of Medical Sciences and Health Services, Shahid Rajaee Hospital, Tehran, Iran

² Associate Professor of Cardiovascular Surgery, Tehran University of Medical Sciences and Health Services, Shariati Hospital, Tehran, Iran

³ Associate Professor of General and Vascular Surgery, Iran University of Medical Sciences and Health Services, Rasoole Akram Hospital, Tehran, Iran

⁴ Resident of Cardiac Surgery, Iran University of Medical Sciences and Health Services, Shahid Rajaee Hospital, Tehran, Iran

⁵ Assistant Professor of Endocrine Embryology and Infertility, Avecina Research Center, Tehran, Iran

Abstract

Introduction & Objective: After cardiac surgery, pericardial effusion occurs in up to 80% of cases,1 it is maximized in size at 10th days after operation.2 Then after it gradually reduces in size. Tamponad occurred in 1% of these patients.1,3 The goal of this study is to reduce the incidence of pericardial effusion after CABG and decreasing mortality and morbidity with posterior pericardiotomy. Materials & Methods: This study was performed in 319 patients undergoing coronary bypass grafting in Shariati Hospital between April 1998 and March 1999. Pericardial effusion in two groups (patients with posterior pericardiotomy or without posterior pericardiotomy) were analyzed and evaluated in these patients. Results: In 31.6% of the patients on the 7th postoperative day, pleural effusion was seen. Posterior pericardiotomy significantly reduced pericardial effusion 7th postoperative days (7.4% in patients with posterior pericardiotomy group and 48.1% in patients without posterior pericardiotomy group (with P-value=0.0001). Posterior pericardiotomy affected and reduced pericardial effusion. Pericardial drainage (pericardial window) only was needed for patients without posterior pericardiotomy (in 4 cases or in 2.5%) (With P-value 0.048). Conclusions: This study shows the better outcome of posterior pericardiotomy. In patients undergoing CABG, if either of the pleural spaces is opened, we recommend posterior pericardiotomy be performed for them.

Keywords

Pericardial Effusion

Posterior Pericardiotomy

Cardiac Tamponad

Incision in Posterior Pericardium