{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:40:59Z","timestamp":1793497259027,"version":"4.5.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Re-thoracotomy due to pericardial effusion is a frequent complication after aortic surgery, leading to prolonged intensive care unit (ICU) and hospital stays and adverse outcomes. This study aims to evaluate the frequency of re-thoracotomy and postoperative atrial fibrillation in patients undergoing ascending aorta replacement with or without posterior left pericardiotomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively analysed clinical data from patients who underwent elective ascending aorta replacement with or without aortic root between January 2014 and June 2024. Patients were divided into two groups based on posterior left pericardiotomy. We assessed re-thoracotomy due to bleeding or pericardial effusion, postoperative atrial fibrillation, ICU and in-hospital stay, as well as mortality rates, adjusting for confounders using propensity score matching.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 256 patients could be included (n\u2009=\u2009140 without and n\u2009=\u2009116 with posterior left pericardiotomy). Mean age was 61.6\u2009\u00b112.2\u2009years, with 27.7% female patients. After matching, re-thoracotomy (12.9% vs 3.4%; P\u2009=\u20090.007) and postoperative atrial fibrillation (36.4% vs 16.4%; P\u2009=\u20090.011) were higher in patients without pericardiotomy. Thirty-day and 1-year mortality were 1.3% and 4.2%, respectively. Posterior left pericardiotomy was associated with shorter ventilation time (8.0 vs 15.0\u2009hours; P\u2009&amp;lt;\u20090.001) and hospital stay (8.0 vs 12.0\u2009days; P\u2009&amp;lt;\u20090.001). Similar results were observed between the unmatched and the matched cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Posterior left pericardiotomy is a simple surgical manoeuvre associated with lower rates of re-thoracotomy and postoperative atrial fibrillation in elective aortic surgery patients in a retrospective cohort. Further prospective randomized trials should be performed to confirm and highlight the results from our study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf105","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T15:23:37Z","timestamp":1745853817000},"source":"Crossref","is-referenced-by-count":2,"title":["Posterior left pericardiotomy for prevention of re-thoracotomy and postoperative atrial fibrillation in aortic surgery"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9763-7304","authenticated-orcid":false,"given":"Marwan","family":"Hamiko","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Spaeth","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossien","family":"Alirezaei","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihor","family":"Krasivskyi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Rogaczewski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7293-5516","authenticated-orcid":false,"given":"Miriam","family":"Silaschi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Salamate","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali El-Sayed","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3042-7182","authenticated-orcid":false,"given":"Farhad","family":"Bakhtiary","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Heart Center Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"2025052403260771900_ivaf105-B1","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.athoracsur.2020.05.104","article-title":"Postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis","volume":"111","author":"Eikelboom","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2025052403260771900_ivaf105-B2","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s00540-012-1330-9","article-title":"Management of postoperative atrial fibrillation","volume":"26","author":"Omae","year":"2012","journal-title":"J Anesth"},{"key":"2025052403260771900_ivaf105-B3","doi-asserted-by":"crossref","first-page":"e0165754","DOI":"10.1371\/journal.pone.0165754","article-title":"Incidence, predictors, and clinical outcomes of postoperative cardiac tamponade in patients undergoing heart valve surgery","volume":"11","author":"You","year":"2016","journal-title":"PLoS One"},{"key":"2025052403260771900_ivaf105-B4","doi-asserted-by":"crossref","first-page":"288","DOI":"10.23736\/S0031-0808.20.04197-X","article-title":"C. Contemporary management of pericardial effusion","volume":"63","author":"Lazaros","year":"2021","journal-title":"Panminerva Med"},{"key":"2025052403260771900_ivaf105-B5","doi-asserted-by":"crossref","first-page":"E84","DOI":"10.1532\/HSF98.20111128","article-title":"The use of posterior pericardiotomy technique to prevent postoperative pericardial effusion in cardiac surgery","volume":"15","author":"Cakalagaoglu","year":"2012","journal-title":"Heart Surg Forum"},{"key":"2025052403260771900_ivaf105-B6","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/S1010-7940(05)80063-6","article-title":"Posterior pericardiotomy reduces the incidence of supra-ventricular arrhythmias following coronary artery bypass surgery","volume":"9","author":"Mulay","year":"1995","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025052403260771900_ivaf105-B7","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.jtcvs.2016.11.057","article-title":"Systematic review and meta-analysis of randomized controlled trials assessing safety and efficacy of posterior pericardial drainage in patients undergoing heart surgery","volume":"153","author":"Gozdek","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025052403260771900_ivaf105-B8","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1016\/S0140-6736(21)02490-9","article-title":"Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial","volume":"398","author":"Gaudino","year":"2021","journal-title":"Lancet"},{"key":"2025052403260771900_ivaf105-B9","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0002-8703(88)90255-4","article-title":"Pericardial effusion after cardiac surgery: incidence, relation to the type of surgery, antithrombotic therapy, and early coronary bypass graft patency","volume":"116","author":"Ikaheimo","year":"1988","journal-title":"Am Heart J"},{"key":"2025052403260771900_ivaf105-B10","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/icvts\/ivr099","article-title":"Does posterior pericardiotomy reduce the incidence of atrial fibrillation after coronary artery bypass grafting surgery?","volume":"14","author":"Kaleda","year":"2012","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2025052403260771900_ivaf105-B11","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.athoracsur.2024.01.021","article-title":"EACTS\/STS guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ","volume":"118","author":"Czerny","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"2025052403260771900_ivaf105-B12","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.jtcvs.2013.10.050","article-title":"Early postoperative bleeding is independently associated with increased surgical mortality in infants after cardiopulmonary bypass","volume":"148","author":"Wolf","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025052403260771900_ivaf105-B13","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s00246-018-2031-4","article-title":"Risk of clinically relevant pericardial effusion after pediatric cardiac surgery","volume":"40","author":"Adrichem","year":"2019","journal-title":"Pediatr Cardiol"},{"key":"2025052403260771900_ivaf105-B14","first-page":"713","article-title":"The role of posterior pericardiotomy on the incidence of atrial fibrillation after coronary revascularization","volume":"44","author":"Arbatli","year":"2003","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"2025052403260771900_ivaf105-B15","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/icvts\/ivt123","article-title":"A randomized trial of early versus delayed mediastinal drain removal after cardiac surgery using silastic and conventional tubes","volume":"17","author":"Moss","year":"2013","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2025052403260771900_ivaf105-B16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.athoracsur.2017.07.045","article-title":"Pericardial blood as a trigger for postoperative atrial fibrillation after cardiac surgery","volume":"105","author":"St-Onge","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2025052403260771900_ivaf105-B17","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/s41569-019-0166-5","article-title":"Postoperative atrial fibrillation: mechanisms, manifestations and management","volume":"16","author":"Dobrev","year":"2019","journal-title":"Nat Rev Cardiol"},{"key":"2025052403260771900_ivaf105-B18","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.athoracsur.2014.03.039","article-title":"Postoperative atrial fibrillation significantly increases mortality, hospital readmission, and hospital costs","volume":"98","author":"LaPar","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2025052403260771900_ivaf105-B19","doi-asserted-by":"crossref","first-page":"1090102","DOI":"10.3389\/fcvm.2022.1090102","article-title":"Effect of posterior pericardiotomy in cardiac surgery: a systematic review and meta-analysis of randomized controlled trials","volume":"9","author":"Soletti","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2025052403260771900_ivaf105-B20","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/j.1540-8191.2005.2004123.x","article-title":"Risk factors of postoperative atrial fibrillation after cardiac surgery","volume":"20","author":"Auer","year":"2005","journal-title":"J Card Surg"},{"key":"2025052403260771900_ivaf105-B21","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/ejcts\/ezx039","article-title":"Postoperative atrial fibrillation following cardiac surgery: a persistent complication","volume":"52","author":"Greenberg","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025052403260771900_ivaf105-B22","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.jtcvs.2015.10.113","article-title":"Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement","volume":"151","author":"Svensson","year":"2016","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivaf105\/63021727\/ivaf105.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/5\/ivaf105\/63021727\/ivaf105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/5\/ivaf105\/63021727\/ivaf105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T07:26:16Z","timestamp":1748071576000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivaf105\/8121156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,6]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaf105","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,4,28]]},"article-number":"ivaf105"}}