Reoperation is difficult if the right ventricle is attached to the sternum. Initial pericardial closure prevents the attachment but it could depress the cardiac functions. We search the geometric and hemodynamic effects of parapericardial tissue closure. Twenty-four patients undergoing open heart surgery were randomized into two groups; 12 patients underwent the closure of both of timus lobes, the parapericardial tissue and both side of pleura. In 12 patients, the pericardium was left open (one patient died and was excluded). In all patients, radiopaque markers were attached to the right ventricular epicardium. However, in the closure group, the cardiac indices in 8th and 16th hours (2.9 ± 0.2 and 3 ± 0.2 l/min.m2) did not different from open group (2.8 ± 0.3 and 2.9 ± 0.3 l/min.m2, p > 0.05). The space between epicardium and sternum was not not different between two groups (15 ± 3 mm; vs 14 ± 3 mm; p > 0.05). The thechnique does not have any additional benefit but further investigations and pathological study may reveal the advantage of the technique.

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