Role of posterior pericardiotomy in prevention of Pericardial Effusion and Atrial Fibrillation after coronary artery bypass grafting surgery

ABSTRACT

The aim of this prospective study was to evaluate the efficacy of Posterior Pericardiotomy in decreasing the occurrence and development of Pericardial Effusion and related Atrial Fibrillation [AF] Randomized Control Trial [RCT]. Armed Forces Institute of Cardiology and National Institute of Heart Diseases Rawalpindi, from Jan 2009 to Feb 2010. This prospective randomised study was performed in the first 100 patients undergoing coronary artery bypass grafting surgery [CABG] between January 2009 and February 2010. Patients were randomized into two groups, Posterior Pericardiotomy was performed in 50 patients before releasing aortic cross clamp [Group I]; remaining other 50 patients served as the control Group [Group II]. 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. The difference between the two treatment groups, with regards to age, sex, number of bypass grafts, duration of cross clamp, total perfusion time and hospital stay time were not statistically significant. Atrial Fibrillation was noted in 02 [4%] patients in Group I and 12 [24%] patients in Group II [p 0.004]. Pericardial Effusion was present in 03 patients in Group I and 16 patients in Group II [p <0.001]. Atrial flutter and other supraventricular arrhythmias were not statistically significant. Posterior Pericardiotomy proved to be technically easy and efficient procedure in decreasing the occurrence and development of Pericardial Effusion and related Atrial Fibrillation [AF]