title: Effect of posterior pericardial drainage on the incidence of pericardial effusion after ascending aortic surgery.
abstract: OBJECTIVE
  Pericardial effusion and cardiac tamponade after ascending aortic surgery are higher than anticipated after cardiac surgery. We evaluated a thin closed-suction drain system to prevent posterior pericardial effusion in patients undergoing ascending aortic surgery.
  
  
  METHODS
  One hundred forty patients who underwent ascending aortic surgery were prospectively randomized into group A and group B. In group A (n = 70) we used a 32F drain placed anteriorly overlying the heart and a 16F thin drain placed retrocardially. In group B (n = 70) only a 32F drain placed anteriorly was used. In group A we removed the large drain on the first postoperative day and continued drainage with the thin drain until the drainage was less than 50 mL in a 24-hour period. In group B we removed the drain after the first postoperative day when the drainage was less than 50 mL in an 8-hour period. Preoperative, perioperative, and postoperative parameters of the patients were compared.
  
  
  RESULTS
  No significant posterior pericardial effusion and late cardiac tamponade developed in patients in group A. In group B 10 (14.3%) patients experienced significant posterior pericardial effusion and 4 (5.7%) patients experienced late cardiac tamponade; the incidence of significant pericardial effusion in group B was significantly higher (P = .001). Postoperative new-onset atrial fibrillation developed in 6 (10.4%) patients in group A and in 18 (32.7%) patients in group B (P = .03).
  
  
  CONCLUSIONS
  We demonstrated that effective posterior drainage is important to prevent posterior pericardial effusion, and use of a thin drain placed retrocardially appears to be sufficient for these results.
authors.affiliation: Department of Cardiovascular Surgery, Ankara University, School of Medicine, Ankara, Turkey.
authors.forename: Sadik
authors.initials: S
authors.lastname: Eryilmaz
authors.forename: Ozan
authors.initials: O
authors.lastname: Emiroglu
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Eyileten
authors.forename: Ruchan
authors.initials: R
authors.lastname: Akar
authors.forename: Levent
authors.initials: L
authors.lastname: Yazicioglu
authors.forename: Refik
authors.initials: R
authors.lastname: Tasoz
authors.forename: Bulent
authors.initials: B
authors.lastname: Kaya
authors.forename: Adnan
authors.initials: A
authors.lastname: Uysalel
authors.forename: Kemalettin
authors.initials: K
authors.lastname: Ucanok
authors.forename: Tumer
authors.initials: T
authors.lastname: Corapcioglu
authors.forename: Umit
authors.initials: U
authors.lastname: Ozyurda
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001281:Atrial Fibrillation / Q000453:epidemiology; D002305:Cardiac Tamponade / Q000517:prevention & control; D004322:Drainage / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies