Pericardial closure and paradoxic septal motion after surgery

Area of Science:

• Cardiovascular Surgery
• Cardiac Physiology

Background:

• Paradoxic septal motion is a phenomenon observed after cardiac surgery.
• The role of the pericardium in its development is not fully understood.

Purpose of the Study:

• To investigate the influence of pericardial closure on the development of paradoxic septal motion.
• To assess changes in septal motion and ejection fraction post-cardiac surgery.

Main Methods:

• M-mode echocardiograms analyzed in 29 patients before and after cardiac surgery.
• Patients were randomly assigned to either pericardial closure or non-closure groups.
• Echocardiographic parameters including septal motion and ejection fraction were measured.

Main Results:

• Paradoxic septal motion occurred in 42% of patients with a sutured pericardium and 65% without closure (not statistically significant).
• Septal motion significantly decreased post-surgery in both groups (P < .001).
• Echocardiographically derived ejection fraction decreased from 71% to 60% (P < .001).

Conclusions:

• Pericardial closure does not play a significant role in the development of paradoxic septal motion.
• Septal motion impairment and reduced ventricular function are common after cardiac surgery, irrespective of pericardial management.