Effect of posterior pericardiotomy on postoperative supraventricular arrhythmias and late pericardial effusion (posterior pericardiotomy)

Objective: The aim of this prospective study was to evaluate the effectiven ess of posterior pericardiotomy from the point of pericardial effusion rela ted with supraventricular tachycardia and development of delayed posterior cardiac effusions, Materials and Methods: This prospective randomized study was carried out in 200 patients undergoing coronary artery bypass surgery in Gulhane Medical Academy Department of Cardiovascular Surgery between Jun e 1996 and June 1997. Patients were divided into 2 groups; each group inclu ded 100 patients, Longitudinal incision was made parallel and posterior to the left phrenic nerve, extending from the left inferior pulmonary vein to the diaphragm in group I patients. Posterior pericardiotomy was not done in group II. Results: Atrial fibrillation was developed in 6 patients (6%) in group I and in 34 patients (34%) in group II (P = .0000007). Atrial nutter and other supraventricular arrhythmia prevalence was not statistically sig nificant. Early and late pericardial effusion were developed 54% and 21%, r espectively, in group II, but neither early nor late pericardial effusion w ere developed in group I (P = .00001). Delayed pericardial tamponade was al so significantly lower in group I (0% vs 10%; P = .001). Conclusion: Poster ior pericardiotomy is technically easy to perform and a safe and effective technique that reduces not only the prevalence of early pericardial effusio n and related atrial fibrillation but also delayed posterior pericardial ef fusion and tamponade.