Grant: Project Grant

After heart surgery, fluid can collect in the sac that surrounds the heart and this has been linked to patients developing an irregular heartbeat, called atrial fibrillation. Atrial fibrillation is the most common complication after heart surgery and is an important risk factor for stroke and other complications like unplanned visits to hospital. We think that making a small cut in the sac around the heart will prevent fluid collecting in the sac after surgery, and therefore prevent the irregular heartbeat and other complications. A small study at one hospital showed that this cut in the sac around the heart reduced fluid collection and atrial fibrillation, but we need to run a larger study at more hospitals and in more patients to answer if this procedure is effective and safe for patients. The PRINCE Trial will be run in about 40 hospitals around the world and will include about 1200 adult patients having heart surgery for another reason. These patients will be randomized, like flipping a coin, to either have a small cut in the sac around their heart during surgery or no cut in the sac. The goal of this study is to determine if making a small cut in the sac around the heart prevents patients from developing atrial fibrillation or other complications after surgery. Patients will be followed for an average of 5 years after their heart surgery to determine any complications they may have.