title: Pericardium closure after heart operations: a safety option?
abstract: OBJECTIVE
  Primary pericardium closure may reduce the risk of cardiac injury during chest re opening, especially the right ventricle, aorta and coronary bypass grafts. Nevertheless, concern about adverse hemodynamic effects prevents most heart surgeons of closuring the pericardium.
  
  
  METHODS
  We evaluated 48 patients undergoing open heart surgery consecutively which the pericardium was closed in 30 patients (group A) and 18 patients, as a control group (group B) in which the pericardium was left open. All patients underwent posteroanterior and lateral chest roentgenograms before surgery and one week postoperatively. Postoperative evaluation also included echocardiograms, ECG and postoperative enzyme analysis.
  
  
  RESULTS
  There were no deaths or any complications in both groups (acute myocardial infarction, stroke, bleeding or cardiac tamponate). It was observed statistically differences between both groups especially in echocardiogram parameters and cardiothoracic ratio without clinical impact.
  
  
  CONCLUSIONS
  Pericardium closure is a simple method to facilitate resternotomy during subsequent re operative procedures. However, cardiac surgeons should be aware of the transient deterioration in hemodynamics associated with it, even thought there was no clinical significance in this study.
authors.affiliation: Hospital de Clínicas Mario Lioni - Amil, Rio de Janeiro, Brazil. cadu.dantas@globo.com
authors.forename: Carlos Eduardo Pereira
authors.initials: CE
authors.lastname: Dantas
authors.forename: Mauro Paes Leme de
authors.initials: MP
authors.lastname: Sá
authors.forename: Eduardo Sergio
authors.initials: ES
authors.lastname: Bastos
authors.forename: Monica M F
authors.initials: MM
authors.lastname: Magnanini
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000601:surgery*; D012086:Reoperation; D019112:Teleradiology; D016896:Treatment Outcome