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Ann Thorac Surg 1976;22:532-534
© 1976 The Society of Thoracic Surgeons

Articles

Should the Pericardium Be Closed after an Open-Heart Operation?

Luis Asanza, M.D., Gattu Rao, M.D., Choudary Voleti, M.D., Marvin L. Hartstein, M.D., B. George Wisoff, M.D.*

From the Division of Cardio-Thoracic Surgery, Department of Surgery, Long Island Jewish-Hillside Medical Center, New Hyde Park, and State University of New York at Stony Brook School of Medicine, Stony Brook, NY

Accepted for publication April 23, 1976.

* Address reprint requests to Dr. Wisoff, Division of Cardio-Thoracic Surgery, Long Island Jewish-Hillside Medical Center, New Hyde Park, NY 11040

A controlled clinical study was carried out to decide whether the pericardium should be left open or closed after open-heart operations. One hundred patients had the pericardium closed with interrupted silk; another 100 had the pericardium left open. Complications were alike except for the more frequent occurrence of a pericardial rub in the closed group (14 vs 3 patients), though the incidence of post-pericardiotomy syndrome was equal. There was no late tamponade. Two early reexplorations for bleeding were done in the open group, none in the closed. There were no postoperative deaths. In the patients who consented to postoperative angiography following revascularization procedures, the incidence of graft failure was equal in both groups.

The pericardium should be closed after an open-heart operation. Morbidity and mortality are unchanged, and repeat cardiac exploration is safer.




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