Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery.

Overview

The posterior left pericardiotomy is a surgical procedure for the prevention of postoperative atrial fibrillation after cardiac surgery. It comprises a 4- to 5-cm longitudinal incision parallel and posterior to the phrenic nerve, extending from the left inferior pulmonary vein to the diaphragm. The pericardiotomy allows for prolonged drainage of dependent blood and pericardial fluid into the left pleural space, which is thought to be irritating to the left atrium, leading to postoperative atrial fibrillation. In this brief video tutorial, we demonstrate our technique for performing a posterior pericardiotomy.