Chronic constrictive tuberculous pericarditis: risk factors and outcome of pericardiectomy

Data on long-term outcome of pericardiectomy are limited. This retrospective study aimed to investigate risk factors and early and late outcomes of pericardiectomy for constrictive tuberculous pericarditis.

Seventy patients with chronic constrictive pericarditis who underwent pericardiectomy between January 1990 and August 2005 were reviewed for perioperative and long-term survival.

Patients (49 males; median age 40 years) had a median duration of symptoms of 24 months (range 8-72) before surgery. Perioperative mortality was 8.6%. During follow-up (mean 66.4 +/- 56.4), late mortality rates at 5 and 10 years were 1.6% and 9.7%, respectively. The mean censored survival in all patients was 155.2 months (SEM 8.3, 95%CI 138.8-171.6). Readmission-free survival was 68.6% over 10 years (mean 125.4 months, SEM 10.3, 95%CI 105.2-145.6). Ascites and duration of symptoms were found to be predictors of perioperative mortality (P = 0.047 and 0.036, respectively).

The optimal time of pericardiectomy is most important in its management. Total or near-total pericardiectomy should always be performed as early as possible.