Posterior Pericardial Window and a Single Pleural Drain: A Dual Defence Against Post-CABG Pericardial Effusion and Atrial Fibrillation
Redoy Ranjan,1,2 Stamatis Kapetanakis,3 Venkatachalam Chandrasekaran,1 Riyaz A Kaba,4 Aziz U Momin1 1Department of Cardiac Surgery, St George’s University Hospitals NHS Foundation Trust, London, UK; 2Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; 3Depa...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-04-01
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| Series: | Therapeutics and Clinical Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/posterior-pericardial-window-and-a-single-pleural-drain-a-dual-defence-peer-reviewed-fulltext-article-TCRM |
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| Summary: | Redoy Ranjan,1,2 Stamatis Kapetanakis,3 Venkatachalam Chandrasekaran,1 Riyaz A Kaba,4 Aziz U Momin1 1Department of Cardiac Surgery, St George’s University Hospitals NHS Foundation Trust, London, UK; 2Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; 3Department of Cardiology, St Thomas’ Hospital, London, UK; 4Department of Cardiology, St George’s University Hospitals NHS Foundation Trust, London, UKCorrespondence: Aziz U Momin, Department of Cardiac Surgery, St George’s University Hospitals NHS Foundation Trust, London, UK, Tel +447956336739, Email a.momin@nhs.netBackground: Postoperative new atrial fibrillation (POAF) commonly occurs after coronary artery bypass graft (CABG) and is often associated with postoperative pericardial effusion. We aimed to investigate the effectiveness of a posterior pericardial window (PPW) with a single left pleural drain in reducing post-CABG pericardial effusion and atrial fibrillation without mediastinal chest drains.Methods: This descriptive observational study evaluated age and sex-adjusted isolated elective on-pump CABG patients into two groups: PPW with only left pleural chest drains and control (routine multiple mediastinal and pleural chest drains. We performed continuous telemonitoring for 96 hours after surgery to assess heart rhythm, followed by daily electrocardiograms. Bedside echocardiography was conducted on postoperative day 4 to check for pericardial effusion.Results: This study evaluated age and sex-adjusted 250 CABG patients, with male predominance (80%) and identical comorbidities between study groups. We found similar age (61.5 ± 7.5 vs 62.6 ± 6.2, P =0.40) and male sex (86.9% vs 74.8%, P =0.13) between the PPW and control groups. Additionally, the sociodemographic and intraoperative variables were the same across the study groups (P > 0.05). The occurrence of > 1cm pericardial effusions (0.8% vs 14.1%, P < 0.001) and postoperative AF (6.9% vs 19.3%, P =0.002) occurrence was significantly lower in the PPW compared to the control group.Conclusion: Despite similar clinical and operative profiles, a posterior pericardial window with a single left pleural drain effectively reduces pericardial effusion and the incidence of postoperative AF following CABG surgery.Keywords: pericardiotomy, pericardial window, atrial fibrillation, coronary artery bypass graft |
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| ISSN: | 1178-203X |