[Pericardectomy and acute infectious pericarditis].

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.

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.