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Posterior pericardial window: a simple and reproducible technique in order to prevent pericardial tamponade in paediatric cardiac surgery

Published online by Cambridge University Press:  12 October 2023

Baran Simsek Open the ORCID record for Baran Simsek [Opens in a new window] ,
Arda Ozyuksel Open the ORCID record for Arda Ozyuksel [Opens in a new window] ,
Murat Saygi  and
Murat Basaran
Baran Simsek*
Affiliation:
Department of Cardiovascular Surgery, Kolan Hospital, Istanbul, Turkey
Arda Ozyuksel
Affiliation:
Department of Cardiovascular Surgery, Biruni University School of Medicine, Istanbul, Turkey
Murat Saygi
Affiliation:
Department of Pediatric Cardiology, Medicana International Hospital, Istanbul, Turkey
Murat Basaran
Affiliation:
Department of Cardiovascular Surgery, Kolan Hospital, Istanbul, Turkey
*
Corresponding author: B. Simsek; Email: simsekbaran7@gmail.com
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Abstract

Objective:

Pericardial tamponade, which increases postoperative mortality and morbidity, is still not uncommon after paediatric cardiac surgery. We considered that posterior pericardiotomy may be a useful and safe technique in order to reduce the incidence of early and late pericardial tamponade. Herein, we present our experience with creation of posterior pericardial window following congenital cardiac surgical procedures.

Methods:

This retrospective study evaluated 229 patients who underwent paediatric cardiac surgical procedures between June 2021 and January 2023. A posterior pericardial window was created in all of the patients. In neonates and infants, pericardial window was performed at a size of 2x2 cm, whereas a 3x3 cm connection was established in elder children and young adults. A curved chest tube was placed and positioned at the posterolateral pericardiophrenic sinus. An additional straight anterior mediastinal chest tube was also inserted in every patient. Transthoracic echocardiographic evaluations were performed daily to assess postoperative pericardial effusion.

Results:

A total of 229 (135 male, 94 female) patients were operated. Mean age and body weight were 24.2 ± 26.7 months and 10.2 ± 6.7 kg, respectively. Eight (3.5%) of the patients were neonates where 109 (47.6%) were infants and 112 (48.9%) were in childhood. Fifty-two (22.7%) re-do operations were performed. Six (2.6%) patients underwent postoperative surgical re-exploration due to surgical site bleeding. Any early or late pericardial tamponade was not encountered in the study group.

Conclusions:

Posterior pericardial window is an effective and safe technique in order to prevent both the early and late pericardial tamponade after congenital cardiac surgery.

Keywords

Cardiac tamponadepericardial effusionspericardial window techniquesCHDposterior pericardiotomy
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 4 , April 2024 , pp. 765 - 770
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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