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Related Experiment Videos

Pericardial closure.

C H Bahn, L S Annest, M Miyamoto

    American Journal of Surgery
    |May 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Closing the pericardium after coronary bypass surgery protects the heart and may reduce cardiac tamponade. While a mild compression effect is noted, it does not negatively impact patient outcomes, allowing for safe internal mammary artery use.

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    Area of Science:

    • Cardiac Surgery
    • Thoracic Surgery
    • Cardiovascular Research

    Background:

    • Pericardial closure following coronary artery bypass grafting (CABG) is a debated topic.
    • Potential benefits include protection of the right ventricle and bypass grafts during re-sternotomy.
    • Concerns exist regarding potential cardiac compression and interference with grafts.

    Purpose of the Study:

    • To evaluate the clinical and hemodynamic implications of pericardial closure after CABG.
    • To assess the protective effects against right ventricular injury and cardiac tamponade.
    • To determine the feasibility and impact on internal mammary artery (IMA) conduits.

    Main Methods:

    • Review of clinical outcomes and hemodynamic data in patients undergoing CABG with and without pericardial closure.

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  • Analysis of incidence of cardiac tamponade and need for re-operation.
  • Assessment of graft patency and flow dynamics, particularly for IMA grafts.

    • Main Results:

    • Pericardial closure was associated with decreased incidence of cardiac tamponade and provided protection to the right ventricle and grafts.
    • A mild, transient compressive effect on the heart was observed but did not lead to adverse clinical outcomes.
    • Hemodynamic studies confirmed no significant detrimental impact on cardiac function.
    • The supracardiac portion of the pericardium was intentionally left open to accommodate IMA conduits.

    Conclusions:

    • Routine pericardial closure after CABG is recommended for its protective benefits, including reduced tamponade risk and graft protection.
    • The procedure is feasible in most cases, with specific contraindications including anticipated cardiac bleeding or interference with IMA pedicles.
    • Clinical and hemodynamic data support the safety and efficacy of pericardial closure in selected patients.