AHA 2021 | PALACS: Posterior Left Pericardiotomy Improves Post-Procedural AF

Posterior left pericardiotomy for the prevention of atrial fibrillation during cardiac surgery seems to significantly reduce atrial fibrillation risk (AF) after procedure.

AHA 2021 | PALACS: la pericardiotomía posterior izquierda mejora la FA post operatoria

The procedure consists of a 4-5 cm incision in the posterior pericardium to allow drainage of fluids and thrombi from the pericardium to the pleural cavity during postoperative period. 

Patients receiving the incision during surgery to coronary arteries, aortic valve, or ascending aorta showed a significantly lower rate of postoperative AF (17% vs 32%; RR 0.55; 95% CI 0.39-0.78), with no increase in perioperative complications.

The PALACS randomized 420 patients to receiving or not posterior left pericardiotomy as part of their surgery.  

Seeing as atrial fibrillation is one of the most frequent postoperative complication, this study should by confirmed in a large multicenter study. The PALACS was limited by the single-center design, and the fact that it was not powered to detect differences in clinical events. 

Original Title: Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial.

Reference: Mario Gaudino et al. Presentado en las sesiones científicas del AHA 2021 y publicado simultáneamente en Lancet. 2021 Nov 12;S0140-6736(21)02490-9. Online ahead of print. doi: 10.1016/S0140-6736(21)02490-9. 


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....