A review of the current status of pericardial closure following cardiac surgery

Abstract

Some cardiac surgeons prefer to close the pericardium whenever possible following surgery, others specifically avoid this practice, and still others believe that neither alternative has any meaningful influence on clinical outcomes. Unfortunately, scientific evidence supporting either approach is scarce, making a consensus regarding best practice impossible. In this article, the known functions of the native intact pericardium are summarized, and the arguments for and against pericardial closure after surgery are examined. In addition, the techniques and materials that have been utilized for pericardial closure previously, as well as those that are currently being developed, are assessed.

Keywords::

• biomaterials
• cardiac surgery
• extracellular matrix
• pericardial closure
• pericardial substitutes
• pericardiotomy
• pericardium
• postoperative atrial fibrillation
• resternotomy

Acknowledgements

The authors thank Jeanne McAdara-Berkowitz for expert assistance with manuscript preparation.

Financial & competing interests disclosure

WD Boyd and JL Cox both serve as consultants to CorMatrix Cardiovascular, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Professional writing assistance was used in the preparation of this manuscript. Funds for this assistance were provided by CorMatrix Cardiovascular. The authors maintained full and direct control over all aspects of manuscript development.

Notes

LV: Left ventricle.

Adapted with permission from [107].