title: Does posterior pericardial window technique prevent pericardial tamponade after cardiac surgery?
abstract: OBJECTIVE
  To investigate the efficacy of the intraoperative posterior pericardial window technique in preventing pericardial tamponade following open heart surgery.
  
  
  METHODS
  Adult patients undergoing coronary and/or valve surgery were randomly divided into a control (traditional) or a pericardial window (PW) technique group. Pre-, intra-, peri- and postoperative clinical data were collected prospectively, including incidence of pericardial tamponade, cardiac arrest, drainage volume, ventilation assistance time and moderate-to-large pericardial effusion.
  
  
  RESULTS
  In total, 458 patients were included: 230 controls and 228 in the PW group. The incidence of pericardial tamponade in the PW group was significantly lower than in controls. Cardiac arrest occurred in one patient (0.4%) in the PW group and five (2.2%) controls; this difference was not statistically significant. Moderate-to-large pericardial effusion after drainage extubation and new-onset atrial fibrillation were significantly more common in controls than in the PW group. After stratification by age (≤ 70 versus > 70 years), there was no between-group difference in duration of endotracheal intubation, although in the PW group, after removal of the tracheal cannula, duration of noninvasive positive pressure ventilation was significantly longer in older patients.
  
  
  CONCLUSIONS
  The pericardial window procedure did not increase the rate or severity of procedure-related complications. This simple technique significantly decreased the incidence of postoperative pericardial tamponade and new-onset atrial fibrillation.
authors.affiliation: Cardiovascular Surgery Department, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhao
authors.forename: Zhaoyun
authors.initials: Z
authors.lastname: Cheng
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Quan
authors.forename: Ziniu
authors.initials: Z
authors.lastname: Zhao
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology; D002305:Cardiac Tamponade / Q000453:epidemiology / Q000517:prevention & control*; D004322:Drainage; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000453:epidemiology; D010491:Pericardial Window Techniques; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Pericardial window; atrial fibrillation; cardiac; drainage; surgery; tamponade