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J Thorac Cardiovasc Surg 2007;134:510-511
© 2007 The American Association for Thoracic Surgery

Brief Communication

Rotational pericardial flap: An alternative tension-free technique for pericardial closure

Faranak Kargar, MD, Mathias H. Aazami, MD*

Iran University of Medical Sciences, Rajaei Heart Center, Cardiac Surgery Department, Tehran, Iran.

Received for publication March 29, 2007; accepted for publication April 20, 2007.

* Address for reprints: Mathias Aazami, MD, Cardiac Surgery Department, Rejaei Heart Center, Melat Park, Tehran, Iran. (Email: mathias.aazami@laposte.net).

The first 20% of the full text of this article appears below.

Closing the pericardium in patients with preserved ventricular function has been proposed as a protective measure attempting to minimize the hazards of injuring the myocardium, coronary grafts, and great vessels at the time of reoperation.1Go Despite its own set of advantages, in view of the increasing number of cardiac reoperations, classical pericardial closure has not gained increasing acceptance, mainly because of concerns over its attendant adverse hemodynamic effects.2,3Go In the interim, using alternative techniques deemed as tension-free pericardial closure or pericardial substitutes has been advocated to benefit patients with safer resternotomy while minimizing the adverse effects on immediate postoperative hemodynamics.4,5Go Following this line of reasoning, we report an alternative technique for tension-free pericardial closure that results in layering the right ventricular free wall and infundibulum by means of a rotational pericardial flap while leaving the great vessels unlayered, thereby minimizing the likelihood of compressive effects on the great vessels and top-end anastomosis.

Clinical Summary

After median sternotomy, the prepericardial . . . [Full Text of this Article]






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