Closure of pericardium using pericardial fat in primary cardiac operations

Redo cardiac surgery is generally considered to be at increased risk because of accidental injury to cardiac chambers, great vessels or previous grafts. Pericardial closure is considered best to prevent injuries associated with re-sternotomy. But closure of the pericardium can be associated with coronary graft distortion, impaired left ventricle function or cardiac tamponade. Here we describe a simple technique using pedicled pericardial fat to provide a tension free closure of the pericardium and thus preventing accidental injuries during re-entry and adverse haemodynamic effects of primary pericardial closure.