Key result
Posterior pericardiotomy reduces postoperative pericardial effusion ~78% after cardiac surgery.
Why the study?
Pericardial effusion, tamponade, and atrial fibrillation are challenging complications after cardiac surgeries, and the impact of posterior pericardiotomy on their prevention needed evaluation.
Does posterior pericardiotomy reduce pericardial effusion and cardiac tamponade in adult patients undergoing open-heart surgery?
RCT (n=330)
Single-blind
Simple randomization
No
Does posterior pericardiotomy reduce pericardial effusion and cardiac tamponade in adult patients undergoing open-heart surgery?
Odds Ratio: 0.223 (95% CI 0.122–0.407)
Absolute Event Rate: 20.6% vs 49.7%
p-value: p=<0.001
Posterior pericardiotomy is a safe and effective surgical technique that significantly reduces the incidence of postoperative pericardial effusion, cardiac tamponade, and atrial fibrillation after open-heart surgery.
May support routine posterior pericardiotomy in cardiac surgery; confirms benefit via RCT.
PURPOSE: Pericardial effusion (PE), tamponade, and atrial fibrillation are challenging complications after cardiac surgeries. This prospective randomized study was conducted to evaluate the impact of posterior pericardiotomy (PP) in the prevention of PE and cardiac tamponed after adult cardiac surgery. METHODS: This single-center, prospective, randomized controlled trial included 330 patients undergoing open-heart surgery. They were randomly assigned to either a PP group or a control group. RESULTS: Of 703 screened patients, 330 were enrolled from January 2022 to June 2024 (mean age: 50.2 ± 14.7 years, 64.2% males). Compared to controls, the PP group had significantly lower early and late PE (19.4% vs. 44.8%, and 4.2% vs. 17%, respectively), tamponade (2.4% vs. 11.5%), and postoperative atrial fibrillation (10.3% vs. 19.4%). PP also significantly reduced the need for surgical re-exploration, duration of mechanical ventilation, and both intensive care unit and overall hospital stays (all P <0.05). Adjusted multivariate analysis confirmed the benefits of PP after correcting for baseline imbalances in left ventricular ejection fraction and operative time. No adverse events directly attributable to PP were noted. CONCLUSIONS: PP is a simple, safe, and effective technique for reducing postoperative PE, and cardiac tamponade after cardiac surgery.
No takes yet. Share an insight, caveat, or question.
Al-Shameri et al. (2025) conducted an RCT in Open-heart surgery (CABG, valvular, or combined) (n=330). Posterior pericardiotomy vs. No intervention was evaluated on Pericardial effusion (OR 0.223, 95% CI 0.122-0.407, p=<0.001). Posterior pericardiotomy significantly reduced the incidence of postoperative pericardial effusion (20.6% vs 49.7%, OR 0.223) and cardiac tamponade compared to no intervention after cardiac surgery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: