Pericardiectomy for constrictive pericarditis: single-center experience in China

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Surgery

Background:

• Pericardiectomy is a critical procedure for constrictive pericarditis (CP).
• High rates of morbidity and mortality are associated with pericardiectomy.
• Understanding predictors of complications is essential for patient management.

Purpose of the Study:

• To evaluate predictors of in-hospital complications and outcomes.
• To assess the safety and efficacy of pericardiectomy for CP in a Chinese single-center cohort.

Main Methods:

• Retrospective evaluation of 165 patients undergoing pericardiectomy for CP (1990-2012).
• Analysis of perioperative data, complications, and long-term survival.
• Identification of factors associated with increased mortality and morbidity.

Main Results:

• Mean age was 36.79 ± 18.52 years; 91.5% underwent median sternotomy.
• Unadjusted mortality was 5.4%, with low cardiac output syndrome as the main cause of death.
• Major complications included low cardiac output syndrome, reoperation for bleeding, pneumonia, mediastinitis, chylothorax, and cerebral infarction.
• One-year survival was 92%; advanced NYHA class, age, cardiopulmonary bypass, and hemodialysis predicted worse outcomes.

Conclusions:

• Total pericardiectomy offers reduced perioperative and late mortality.
• Individualized pericardial resection extent is recommended.
• Optimal perioperative management and complete release of thickened pericardium are key to preventing complications.