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Constrictive pericarditis after cardiac surgery.

D M Killian1, J G Furiasse, P J Scanlon

  • 1Department of Medicine, Loyola University Medical Center, Maywood, IL 60153.

American Heart Journal
|September 1, 1989
PubMed
Summary
This summary is machine-generated.

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Constrictive pericarditis after cardiac surgery can be diagnosed with computerized tomography. Pericardial stripping improved symptoms in most patients, though some required further intervention or succumbed to complications.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Thoracic Surgery

Background:

  • Constrictive pericarditis is a potential complication following cardiac surgery.
  • Postpericardiotomy syndrome may precede the development of constriction.
  • Diagnosis and management of post-cardiac surgery constrictive pericarditis remain challenging.

Purpose of the Study:

  • To evaluate the clinical characteristics, diagnostic methods, and treatment outcomes of constrictive pericarditis after cardiac surgery.
  • To assess the efficacy and safety of surgical intervention (pericardial stripping) versus medical management.

Main Methods:

  • Retrospective review of 45 patients diagnosed with constrictive pericarditis post-cardiac surgery.
  • Analysis of clinical data, diagnostic imaging (including computerized tomography), and treatment outcomes.

Related Experiment Videos

  • Comparison of outcomes between patients treated with pericardial stripping and those managed medically.

    • Main Results:

    • Mean age was 61 years; mean interval to constriction was 23.4 months.
    • Computerized tomography accurately diagnosed constriction in 79% of cases.
    • Pericardial stripping led to marked symptomatic improvement in 28 of 37 patients (76%).
    • Four patients (11%) experienced mortality within 30 days of pericardial stripping.
    • Medical therapy alone was used in 8 patients, with variable outcomes.

    Conclusions:

    • Constrictive pericarditis following cardiac surgery is a significant concern with a notable interval to presentation.
    • Computerized tomography is a valuable tool for diagnosis.
    • Pericardial stripping offers substantial symptomatic relief for selected patients, but carries risks.
    • Careful patient selection and consideration of medical therapy are crucial.