Impact of the total pericardial closure using bilateral trap door incision and pericardial cavity intervention on outcomes following coronary artery bypass grafting: a randomized, controlled, parallel-group prospective study

Abstract

Total pericardiorrhaphy with pericardial cavity intervention can be acceptable and favourable in terms of its outcomes, including reducing incidence of postoperative atrial fibrillation, pericardial effusion and length of hospitalization.

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).…”

“…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. 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.…”

“…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.…”

“…Kaya and colleagues 31 Three drains in study group, one in the left pleural cavity, one in the anterior mediastinum and the other in the pericardial sac along the right atrium. Pericardium was closed.…”

Posterior Pericardial Drainage in Patients with Heart Surgery

“…The corresponding event rates were 0.42% (6/1431) versus 4.95% (70/1413). (18) 2006 0 50 1 50 0.33 Eryilmaz et al (19) 2006 2 70 6 70 0.31 Bakhshandeh et al (20) 2009 0 205 10 205 0.05 Kaygin et al (24) 2011 0 213 7 212 0.06 Zhao et al (25) 2014 3 228 13 230 0.22 Kaya et al (26) 2014 0 63 4 33 0.05 Fawzy et al (27) 2015 0 100 3 100 0.14 Kaya et al (29) 2015 1 70 1 72 1.03 Kaya et al (30) 2016 0 103 4 107 0.11 total (95% CI) 1156 1138 0.12…”