title: The use of posterior pericardiotomy technique to prevent postoperative pericardial effusion in cardiac surgery.
abstract: OBJECTIVE
  The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).
  
  
  METHODS
  We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.
  
  
  RESULTS
  The 2 groups were not significantly different with respect to demographic and operative data (P > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (P < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (P < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (P = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.
  
  
  CONCLUSIONS
  Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.
authors.affiliation: Cardiovascular Surgery Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey.
authors.forename: Canturk
authors.initials: C
authors.lastname: Cakalagaoglu
authors.forename: Cengiz
authors.initials: C
authors.lastname: Koksal
authors.forename: Ayse
authors.initials: A
authors.lastname: Baysal
authors.forename: Gokhan
authors.initials: G
authors.lastname: Alıcı
authors.forename: Birol
authors.initials: B
authors.lastname: Ozkan
authors.forename: Kamil
authors.initials: K
authors.lastname: Boyacioglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tasar
authors.forename: Emine Banu
authors.initials: EB
authors.lastname: Atasoy
authors.forename: Hasan
authors.initials: H
authors.lastname: Erdem
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Esen
authors.forename: Mete
authors.initials: M
authors.lastname: Alp
mesh_terms: D002305:Cardiac Tamponade / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000453:epidemiology* / Q000517:prevention & control*; D010492:Pericardiectomy / Q000379:methods* / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology