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[Pericardectomy and acute infectious pericarditis].

U Niederhäuser1, M Vogt, L K von Segesser

  • 1Klinik für Herzgefässchirurgie, Universitätsspital Zürich.

Schweizerische Medizinische Wochenschrift
|February 1, 1992
PubMed
Summary

Pericardectomy is a safe and effective treatment for acute infectious pericarditis, particularly purulent cases, leading to low mortality and improved heart function. Early surgical intervention prevents long-term complications like cardiac constriction.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Thoracic Surgery

Context:

  • Acute infectious pericarditis presents with diverse etiologies including bacterial, tuberculous, viral, and fungal infections.
  • Clinical manifestations range from tamponade/shock to edema and hepatomegaly, with pericardiocentesis often providing insufficient drainage and limited microbiological yield.
  • Preoperative functional status, assessed by NYHA class, is typically poor in patients with infectious pericarditis.

Purpose:

  • To evaluate the safety and long-term outcomes of pericardectomy in patients with acute infectious pericarditis.
  • To assess the efficacy of pericardectomy in preventing constrictive pericarditis and improving cardiac function.
  • To determine the mortality rates and postoperative complications associated with pericardectomy for infectious pericarditis.

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Summary:

  • A cohort of 12 patients with acute infectious pericarditis underwent pericardectomy between 1980 and 1990.
  • The study found a low overall mortality (8%), with no deaths in purulent pericarditis cases, and significant improvement in NYHA class post-surgery.
  • Pericardectomy, combined with antimicrobial therapy, demonstrated excellent long-term results, preventing cardiac constriction in surviving patients.

Impact:

  • Pericardectomy is a safe and effective treatment for acute infectious pericarditis, especially purulent forms.
  • Early surgical intervention leads to rapid cardiac decompression, removal of infected tissue, and prevention of late constrictive pericarditis.
  • The procedure offers excellent long-term survival rates and functional recovery, significantly improving patients' quality of life.