Pericardial complications are very common following cardiac surgery. It is estimated that up to 30–40% of patients may develop a postpericardiotomy syndrome (PPS) and >50–60% of patients show pericardial effusions after cardiac surgery.1 2 Pericardial complications may range from asymptomatic pericardial and/or pleural effusion to cardiac tamponade, and may include PPS, and postoperative atrial fibrillation (POAF), triggered by pericarditis in predisposed individuals.3 All these complications may prolong the duration of hospitalisation, significantly increase management costs and may also severely impair patient quality of life, often delaying postoperative rehabilitation. On this basis, prevention of pericardial postoperative complications is of paramount importance in clinical practice.

The aim of the present systematic review by Malektojari et al is to evaluate the efficacy and safety of proposed preventive strategies for the prevention of such complications with a main focus on PPS, pericardial effusion, pericarditis and POAF.4

The authors …