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Updated: Jun 6, 2026
10:52
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Pericardium closure after heart operations: a safety option?
Carlos Eduardo Pereira Dantas1, Mauro Paes Leme de Sá, Eduardo Sergio Bastos
1Hospital de Clínicas Mario Lioni - Amil, Rio de Janeiro, Brazil. cadu.dantas@globo.com
Summary
Closing the pericardium during open heart surgery may simplify re operations and reduce cardiac injury risk. While transient hemodynamic changes occurred, no significant adverse events were noted in this study.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- Primary pericardium closure during open heart surgery is debated due to concerns over adverse hemodynamic effects.
- Potential benefits include reduced risk of cardiac injury during re-sternotomy, particularly to the right ventricle, aorta, and coronary bypass grafts.
Purpose of the Study:
- To evaluate the safety and impact of primary pericardium closure in patients undergoing open heart surgery.
- To assess the potential benefits and risks associated with pericardium closure versus leaving it open.
Main Methods:
- A consecutive series of 48 patients undergoing open heart surgery were divided into two groups: 30 with pericardium closure (Group A) and 18 with the pericardium left open (Group B).
- Preoperative and postoperative chest roentgenograms, echocardiograms, ECGs, and enzyme analyses were performed for all patients.
Main Results:
- No deaths or significant complications (myocardial infarction, stroke, bleeding, cardiac tamponade) were observed in either group.
- Statistically significant differences were found in echocardiogram parameters and cardiothoracic ratio between the groups, but these changes lacked clinical significance.
Conclusions:
- Primary pericardium closure is a straightforward technique that can aid in resternotomy during subsequent reoperative procedures.
- Cardiac surgeons should be cognizant of potential transient hemodynamic deterioration, although it did not prove clinically significant in this study.
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