Posterior pericardiotomy in cardiac surgery: systematic review and meta-analysis.

Autor:	Ali-Hasan-Al-Saegh S; Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran S.alihassan.cardiosurg@gmail.com., Mirhosseini SJ; Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Liakopoulos O; Department of Thoracic and Cardiovascular Surgery, West German Heart Center, Essen University Hospital, Essen, Germany., Sabashnikov A; Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, UK., Dehghan HR; Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Sedaghat-Hamedani F; Department of Medicine III, University of Heidelberg, Heidelberg, Germany., Kayvanpour E; Department of Medicine III, University of Heidelberg, Heidelberg, Germany., Ghaffari N; Department of Cardiovascular Surgery, Herzchirurgie Klinikum, Karlsruhe, Germany., Vahabzadeh V; Department of Cardiovascular Surgery, Herzchirurgie Klinikum, Karlsruhe, Germany., Aghabagheri M; Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Mozayan MR; Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Popov AF; Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2015 Mar; Vol. 23 (3), pp. 354-62. Date of Electronic Publication: 2014 Jun 19.
DOI:	10.1177/0218492314541132
Abstrakt:	This systematic review with meta-analysis sought to determine the impact of posterior pericardiotomy on incidences of atrial fibrillation and supraventricular arrhythmias, pericardial effusion, pleural effusion, tamponade, and the length of hospital stay after cardiac surgery. We searched for randomized controlled trials, using Medline, Embase, Elsevier and Sciences online databases as well as Google Scholar literature. The effect sizes measured were odds ratio for categorical variables and standard mean difference with 95% confidence interval for calculating differences between mean values of hospital stay in intervention and control groups. A value of p < 0.1 for Q test or I(2 )> 50% indicated significant heterogeneity between the studies. The literature search of all major databases retrieved 20 studies. After screening, 12 suitable trials were identified, which reported outcomes of 2052 patients undergoing cardiac surgery. Posterior pericardiotomy had an odds ratio of 0.33 [95% confidence interval: 0.18-0.61] p < 0.001 for atrial fibrillation; odds ratio 0.32 [0.15-0.67] p = 0.003 for supraventricular arrhythmias; odds ratio 0.09 [0.04-0.19] p = 0.000 for early pericardial effusion and odds ratio 0.04 [0.02-0.08] p < 0.001 for late pericardial effusion; odds ratio 1.64 [1.23-2.20] p = 0.001 for pleural effusion, odds ratio 0.07 [0.02-0.27] p < 0.001 for tamponade, and standard mean difference = 0.01 [-0.12 to 0.14] p = 0.8 for hospital stay. Posterior pericardiotomy is a simple intraoperative technique that can improve postoperative clinical outcomes. However, the incidence of pleural effusion associated with posterior pericardiotomy might be higher. (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)
Databáze:	MEDLINE
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