Evaluation of Different Strategies of Pericardial Drainage After Aortic Valvular Surgery
Evaluation of Different Strategies of Pericardial Drainage After Aortic Valvular Surgery
The incidence of pericardial effusion and late cardiac tamponade after aortic and valvular
 surgery is higher than after other cardiac surgical procedures. The aim of this study is to
 evaluate the clinical safety and efficacy of prolonged mediastinal drainage using small, soft
 silastic drains (Blake drain, Ethicon USA) versus conventional mediastinal drainage using
 large chest tubes. A prospective randomized trial.
The incidence of pericardial effusion and late cardiac tamponade after aortic and valvular
 surgery is higher than after other cardiac surgical procedures. The aim of this study is to
 evaluate the clinical safety and efficacy of prolonged mediastinal drainage using small, soft
 silastic drains (Blake drain, Ethicon USA) versus conventional mediastinal drainage using
 large chest tubes. Patients undergoing aortic and / or valvular surgery will be randomized in
 two groups. In group A, mediastinal drainage will be accomplished using a 28F or 32F chest
 tube in the anterior mediastinum and a 19F Blake drain located in the posterior pericardial
 cavity. In group B, mediastinal drainage will be accomplished using two 28F or 32F chest
 tubes located in the anterior mediastinum. In both groups, conventional chest tubes will be
 removed on the first postoperative day, while patients in the group A will have prolonged
 drainage using the Blake drain until output is less than 50 ml over 24 hour. Patients will be
 followed during their postoperative course for occurrence of significant pericardial effusion
 as detected on routine echocardiogram and late cardiac tamponade requiring reintervention.
Inclusion Criteria:

 -  Patients aged between 18 and 90 years old, undergoing either surgery of the ascending
 and/or transverse aorta, or surgery of the mitral and/or aortic valves

 -  Availability for follow-up at the Montreal Heart Institute Exclusion criteria

 Exclusion Criteria:

 -  Emergency surgery

 -  Unavailability for follow-up at the Montreal Heart Institute