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Stanley Gianelli, Jr., MD; E. Foster Conklin, MD; Stephen M. Ayres, MD; Hiltrud S. Mueller, MD; John J. Gregory, MD
New York

JAMA. 1970;213(6):1038.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Following openheart surgery, relatively small amounts of clots around the heart may critically impair cardiac function, even when the pericardium is left widely open. In a satisfactory system of thoracic drainage the drainage tubes should be located where blood is likely to accumulate, and the tubes should remain patent. During the past 18 months, in over 150 cases, we have employed a system which appears to meet these criteria. All our patients are operated on through a median sternotomy. The pleural cavities are not entered until bypass is completed. Then a wide communication is made between the pericardial sac and the right pleural space, extending posteriorly to within several millimeters of the phrenic nerve. The pericardium is left open in the midline from the diaphragm to the reflection over the aorta.

The right pleural space is drained by a large sump tube in the posterior gutter. A . . . [Full Text PDF of this Article]

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