Closure of the pericardium is important to protect bypass grafts, the great vessels, and the heart from injury due to sternal dehiscence. Furthermore, it is reported to reduce the formation of pericardial adhesions and thus facilitate entry into the chest at resternotomy. We here describe a simple, reproducible, and effective technique for tension-free approximation of the upper pericardium by applying small hemostatic clips to the preserved thymic fascia overlying the pericardium.
NandiP., LeungJ.S., CheungK.L.Closure of pericardium after open heart surgery. A way to prevent postoperative cardiac tamponade. Br Heart J.1976; 38: 1319–1323.
2.
BoydW.D., TybergJ.V., CoxJ.L.A review of the current status of pericardial closure following cardiac surgery. Expert Rev Cardiovasc Ther.2012; 10: 1109–1118.
3.
CunninghamI.N., SpencerF.C., ZeffR., WilliamsC.D., CukingnanR., MullinM.Influence of primary closure of the pericardium after open-heart surgery on the frequency of tamponade, postcardiotomy syndrome, and pulmonary complications. J Thorac Cardiovasc Surg.1975; 70: 119–125.
4.
MeravA.D., BrodmanR., AttaiL.A., RobinsonG.A simple technique for tension-free pericardial closure. Ann Thorac Surg.1979; 28: 399–400.
5.
BadylakS.F., FreytesD.O., GilbertT.W.Extracellular matrix as a biological scaffold material: structure and function. Acta Biomater.2009; 5: 1–13.