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The effect of posterior pericardiotomy after thoracic aortic surgery
BACKGROUND: Postoperative pericardial effusion is common after cardiovascular surgery. We aimed to examine the effectiveness of posterior pericardiotomy in reducing the incidence of postoperative pericardial effusion and postoperative atrial fibrillation after thoracic aortic surgery. METHODS: This...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420293/ https://www.ncbi.nlm.nih.gov/pubmed/36031610 http://dx.doi.org/10.1186/s13019-022-01967-8 |
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author | Maze, Yasumi Tokui, Toshiya Murakami, Masahiko Yamaguchi, Daisuke Inoue, Ryosai Hirano, Koji Nakamura, Bun Ito, Hisato |
author_facet | Maze, Yasumi Tokui, Toshiya Murakami, Masahiko Yamaguchi, Daisuke Inoue, Ryosai Hirano, Koji Nakamura, Bun Ito, Hisato |
author_sort | Maze, Yasumi |
collection | PubMed |
description | BACKGROUND: Postoperative pericardial effusion is common after cardiovascular surgery. We aimed to examine the effectiveness of posterior pericardiotomy in reducing the incidence of postoperative pericardial effusion and postoperative atrial fibrillation after thoracic aortic surgery. METHODS: This study included 201 patients who underwent thoracic aortic open surgery between January 2014 and November 2021. We compared surgical outcomes between patients who underwent posterior pericardiotomy and those who did not. RESULTS: The group that did not undergo posterior pericardiotomy had significantly longer mechanical ventilation duration than the group who did, both in the overall (p = 0.005) and in the propensity-matched cohorts (p = 0.001). The lengths of intensive care unit and hospital stays were significantly longer in the group that did not undergo posterior pericardiotomy compared to the group that did, both in the overall and in the propensity-matched cohorts. The occurrence of postoperative atrial fibrillation and stroke did not differ significantly between the two groups. The amount of pericardial drainage was not significantly lower in the group that underwent posterior pericardiotomy in the overall cohorts (p = 0.09), but the difference was significant in the propensity-matched cohorts (p = 0.04). The amount of mediastinal drainage was significantly lower in the group that underwent posterior pericardiotomy, both in the overall cohorts (< 0.001) and in the propensity-matched cohort (< 0.001). Late pericardial tamponade occurred significantly more frequently in the group that did not undergo posterior pericardiotomy than in the group that did, both in the overall (p = 0.03) and in the propensity-matched cohorts (p = 0.03). CONCLUSIONS: Posterior pericardiotomy has no effect on reducing postoperative atrial fibrillation after thoracic aortic surgery. However, posterior pericardiotomy reduced the occurrence of late pericardial tamponade, length of ICU stay, length of hospital stay, and mechanical ventilation duration after surgery. |
format | Online Article Text |
id | pubmed-9420293 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-94202932022-08-29 The effect of posterior pericardiotomy after thoracic aortic surgery Maze, Yasumi Tokui, Toshiya Murakami, Masahiko Yamaguchi, Daisuke Inoue, Ryosai Hirano, Koji Nakamura, Bun Ito, Hisato J Cardiothorac Surg Research BACKGROUND: Postoperative pericardial effusion is common after cardiovascular surgery. We aimed to examine the effectiveness of posterior pericardiotomy in reducing the incidence of postoperative pericardial effusion and postoperative atrial fibrillation after thoracic aortic surgery. METHODS: This study included 201 patients who underwent thoracic aortic open surgery between January 2014 and November 2021. We compared surgical outcomes between patients who underwent posterior pericardiotomy and those who did not. RESULTS: The group that did not undergo posterior pericardiotomy had significantly longer mechanical ventilation duration than the group who did, both in the overall (p = 0.005) and in the propensity-matched cohorts (p = 0.001). The lengths of intensive care unit and hospital stays were significantly longer in the group that did not undergo posterior pericardiotomy compared to the group that did, both in the overall and in the propensity-matched cohorts. The occurrence of postoperative atrial fibrillation and stroke did not differ significantly between the two groups. The amount of pericardial drainage was not significantly lower in the group that underwent posterior pericardiotomy in the overall cohorts (p = 0.09), but the difference was significant in the propensity-matched cohorts (p = 0.04). The amount of mediastinal drainage was significantly lower in the group that underwent posterior pericardiotomy, both in the overall cohorts (< 0.001) and in the propensity-matched cohort (< 0.001). Late pericardial tamponade occurred significantly more frequently in the group that did not undergo posterior pericardiotomy than in the group that did, both in the overall (p = 0.03) and in the propensity-matched cohorts (p = 0.03). CONCLUSIONS: Posterior pericardiotomy has no effect on reducing postoperative atrial fibrillation after thoracic aortic surgery. However, posterior pericardiotomy reduced the occurrence of late pericardial tamponade, length of ICU stay, length of hospital stay, and mechanical ventilation duration after surgery. BioMed Central 2022-08-28 /pmc/articles/PMC9420293/ /pubmed/36031610 http://dx.doi.org/10.1186/s13019-022-01967-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Maze, Yasumi Tokui, Toshiya Murakami, Masahiko Yamaguchi, Daisuke Inoue, Ryosai Hirano, Koji Nakamura, Bun Ito, Hisato The effect of posterior pericardiotomy after thoracic aortic surgery |
title | The effect of posterior pericardiotomy after thoracic aortic surgery |
title_full | The effect of posterior pericardiotomy after thoracic aortic surgery |
title_fullStr | The effect of posterior pericardiotomy after thoracic aortic surgery |
title_full_unstemmed | The effect of posterior pericardiotomy after thoracic aortic surgery |
title_short | The effect of posterior pericardiotomy after thoracic aortic surgery |
title_sort | effect of posterior pericardiotomy after thoracic aortic surgery |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420293/ https://www.ncbi.nlm.nih.gov/pubmed/36031610 http://dx.doi.org/10.1186/s13019-022-01967-8 |
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