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Pericardiectomy for pericarditis in the pediatric population
Jess L Thompson1, Harold M Burkhart, Joseph A Dearani
1Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
The Annals of Thoracic Surgery
|October 27, 2009
Summary
Pericardiectomy in children is rare but effective for treating pericarditis. This surgery offers good outcomes and symptom resolution for most pediatric patients with refractory pericardial disease.
Area of Science:
- Pediatric Cardiology
- Cardiothoracic Surgery
Background:
- Pericardiectomy is an uncommon procedure in pediatric patients.
- This study reviews the experience with pediatric pericardiectomy.
Purpose of the Study:
- To characterize the experience with pericardiectomy in pediatric patients.
- To evaluate the outcomes of pericardiectomy for inflammatory and constrictive pericarditis in children.
Main Methods:
- A retrospective review of 27 pediatric patients (25 male) who underwent pericardiectomy between 1978 and 2008.
- Indications included inflammatory (16) and constrictive (11) pericarditis.
- Patients had a median symptom duration of 1 year and often received prior aggressive medical treatment, pericardiocentesis, or partial pericardiectomy.
Main Results:
- Complete pericardiectomy was performed in 21 patients.
- Histology confirmed pericarditis in all specimens.
- Median hospital stay was 7 days with an uneventful postoperative course for most.
- 89% of patients achieved complete symptom resolution after a median follow-up of 1 year.
Conclusions:
- Complete pericardiectomy is a safe and effective procedure in selected pediatric patients.
- Symptom resolution is expected in the majority of cases, even with elusive etiology.
- Earlier consideration of pericardiectomy may be beneficial for medically refractory pericarditis.
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