Aim of the Study: To assess the merits and demerits of posterior pericardial drainage in patients undergoing heart surgery. Materials and Methods: A systematic review and meta-analysis of observational studies and randomized controlled trials was conducted. We searched for relevant trials in the Cochrane Library, MEDLINE (from 1980), Embase from 1970 the Transfusion Evidence Library from 1980, and ongoing trial databases; all searches current to 30 September 2017. Results: The search yielded Sixteen randomized controlled trials which included 2755 patients. Results revealed that Posterior pericardial drainage was associated with a significant 90% reduction of the odds of cardiac tamponade versus the control group: (OR 95% confidence interval) 0.13; P < 0.001. The ORs of death or cardiac arrest were significantly decreased by approximately 50% in the posterior pericardial drainage group compared to controls: OR (95% CI): 0.47, P = .028; I2 = 0% Conclusion: Posterior pericardial drainage has been reported in the literature to significantly reduce the prevalence of early pericardial effusion as well as cardiac tamponade. A significant enhanced survival rate was recorded postcardiac surgery.

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