title: The preventive role of the posterior pericardial window in the development of late cardiac tamponade following heart valve surgery.
abstract: It is reported that creating a window from the posterior pericardium into the left pleural cavity during coronary bypass surgeries reduces postoperative late cardiac tamponades. Although late tamponades are more common after heart valve surgeries, this procedure is not generally performed. The present study investigated whether creating a window has a preventive effect on the formation of late cardiac tamponade after heart valve surgeries.
  
  
  
  The study was conducted on all patients (n = 262) in whom one or more valves were replaced and who fulfilled the study criteria between January 2010 and October 2014 in one centre. We began to create a posterior pericardial window in all valvular patients from March 2012. One hundred and thirty-five patients operated on before this date (Non-Window Group) and 127 patients after this date (Window Group) were compared for the development of late cardiac tamponade.
  
  
  
  There were no differences between the groups in terms of preoperative and intraoperative characteristics. Late pericardial tamponade was not observed in any patients from the Window Group, whereas it occurred in 7 (5.2%) patients from the Non-Window Group (P = 0.015). Three patients died in total; all 3 were from the Non-Window Group. One of the mortalities was associated with tamponade.
  
  
  
  Creating a pericardial window may reduce late cardiac tamponade events/episodes, which may be a fatal complication in valve patients. We recommend performing this procedure by allocating some time during the surgical procedure in order to avoid tamponade.
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Ordu University, Ordu, Turkey drkemaluzun@hotmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Uzun
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ordu University, Ordu, Turkey.
authors.forename: Zeki Yuksel
authors.initials: ZY
authors.lastname: Günaydın
authors.affiliation: Department of Cardiovascular Surgery, Özel Avrupa Safak Hospital, Istanbul, Turkey.
authors.forename: Cenk
authors.initials: C
authors.lastname: Tataroǧlu
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ordu University, Ordu, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bektaş
mesh_terms: D000368:Aged; D002305:Cardiac Tamponade / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010491:Pericardial Window Techniques; D010496:Pericardium / Q000601:surgery*; D035422:Pleural Cavity / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Posterior pericardial window; Prevention of late cardiac tamponade; Valve replacement
references.citation: Interact Cardiovasc Thorac Surg. 2012 Apr;14(4):384-9
references.pmid: 22235005
references.citation: J Card Surg. 2005 May-Jun;20(3):257-60
references.pmid: 15854088
references.citation: Ann Thorac Surg. 2002 Oct;74(4):1148-53
references.pmid: 12400760
references.citation: Eur Heart J. 1993 Nov;14(11):1451-7
references.pmid: 8299624
references.citation: J Cardiovasc Med (Hagerstown). 2006 Jul;7(7):533-44
references.pmid: 16801815
references.citation: Thromb Haemost. 1994 May;71(5):633-40
references.pmid: 7522354
references.citation: Can J Surg. 1996 Feb;39(1):42-5
references.pmid: 8599790
references.citation: Chest. 2004 Jun;125(6):2182-7
references.pmid: 15189940
references.citation: J Cardiovasc Surg (Torino). 1996 Dec;37(6):615-20
references.pmid: 9016978
references.citation: J Cardiothorac Vasc Anesth. 2012 Apr;26(2):302-11
references.pmid: 21868250
references.citation: Chest. 1999 Aug;116(2):322-31
references.pmid: 10453858
references.citation: Thorac Cardiovasc Surg. 2005 Oct;53(5):285-90
references.pmid: 16208614
references.citation: Eur J Cardiothorac Surg. 1995;9(3):150-2
references.pmid: 7786532
references.citation: J Thorac Cardiovasc Surg. 1999 Sep;118(3):492-5
references.pmid: 10469966