An original method of pericardium closure after coronary artery bypass grafting

Different cardiac surgery centres have different views regarding pericardial suturing. However, there is limited scientific evidence confirming the advantage of one method over another, which disallows us from forming a general opinion regarding specialists. Here, we describe several well-known methods of suturing the pericardium and preventing traumatisation of coronary bypass grafts and analyse their weaknesses. An original technique of opening and suturing the pericardium is proposed to restore the physiological distinction between the pericardial cavity and the anterior mediastinum during coronary artery bypass grafting without the risk of compromising the functioning coronary bypass grafts and narrow mediastinal syndrome. The proposed method of suturing the pericardium received a patent for invention, No. 2733505, dated 2 October, 2020. In the A.N. Bakulev National Medical Research Center for Cardiovascular Surgery (Moscow, Russian Federation), this technique of suturing the pericardium has been routinely used since 2006. More than 2,000 intraoperative shunt scans have been performed in our department since 2009; all these scans were performed after the pericardium was closed, proving that the fear of compromising the shunts during pericardial suturing is unsupported.