ArticleTherapeutics and clinical risk management2025
Posterior Pericardial Window and a Single Pleural Drain: A Dual Defence Against Post-CABG Pericardial Effusion and Atrial Fibrillation.
Article in Therapeutics and clinical risk management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07194798 (A Prospective Randomized Trial Comparing the Posterior Pericardial Window Versus Retro-Cardiac Drain for the Prevention of Postoperative Atrial Fibrillation and Pericardial Complications Following CABG), which is not on this map. Not yet cited in PubMed.
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A Prospective Randomized Trial Comparing the Posterior Pericardial Window Versus Retro-Cardiac Drain for the Prevention of Postoperative Atrial Fibrillation and Pericardial Complications Following CABG
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Abstract
Background: 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.
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