Six RCTs (n=763 patients) were included in the review, including 379 patients who received posterior pericardiotomy and 384 patients in control groups (table 1). Sequence generation was adequately reported in two trials. The authors stated that all included trials were free of selective reporting and other biases. Allocation concealment, blinding and completeness of outcome data were not reported.
Treatment with posterior pericardiotomy was associated with significantly lower cumulative incidence of atrial fibrillation (OR 0.33, 95% CI 0.16 to 0.69; six RCTs; I2=68%) and supraventricular arrhythmias (OR 0.31, 95% CI 0.15 to 0.65,;five RCTs; I2=70%), but both outcomes were associated with significant heterogeneity.
There were fewer incidences of early pericardial effusion reported after posterior pericardiotomy (OR 0.10, 95% CI 0.04 to 0.28; four RCTs; I2=67%) and late pericardial effusion (OR 0.04, 95% CI 0.01 to 0.21; four RCTs; I2=0%). Early pericardial effusion was associated with significant heterogeneity.
There were no significant differences in pleural effusion or pulmonary complications between intervention and control groups.