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Should the pericardium be closed in patients undergoing cardiac surgery?

Department of Cardiothoracic Surgery, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK

*Corresponding author. Tel. +44 0161 291 5024; fax: +44 0161 2912091.

E-mail address: jamesbbarnard{at}doctors.org.uk (J.B. Barnard).

A best evidence topic in Cardiothoracic Surgery was written according to a structured protocol. The question addressed was in open heart surgery is there any adverse effect to closing the pericardium? Altogether 240 publications were found using the reported search of which 8 were deemed to be relevant to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that the adverse haemodynamic impact of pericardial closure is confirmed in several studies, however, no study has yet reported an adverse clinical outcome due to the closure of the pericardium.

Key Words: Evidence-based medicine; Cardiac surgery; Pericardial closure