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Experience With Pericardiectomy for Constrictive Pericarditis Over Eight Decades
Takashi Murashita1, Hartzell V Schaff1, Richard C Daly1
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
The Annals of Thoracic Surgery
|August 2, 2017
Summary
Surgical outcomes for constrictive pericarditis improved, with lower 30-day mortality after pericardiectomy. However, long-term survival depends on patient factors like disease cause and symptom severity.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Outcomes Research
Background:
- Constrictive pericarditis significantly impacts patient health.
- Pericardiectomy is a key surgical intervention for this condition.
Purpose of the Study:
- To review surgical outcomes of pericardiectomy for constrictive pericarditis.
- To identify risk factors for mortality in a contemporary patient cohort.
Main Methods:
- A retrospective review of 1,071 pericardiectomies performed between 1936 and 2013.
- Patients were categorized into historical (pre-1990) and contemporary (1990-2013) groups for comparative analysis.
Main Results:
- The contemporary group had older patients, more severe symptoms (NYHA class III/IV), and higher rates of concomitant procedures.
- Etiologies shifted from predominantly idiopathic to non-idiopathic causes (postoperative, radiation).
- While 30-day mortality decreased, overall survival remained similar; risk factors for mortality included advanced NYHA class, radiation/post-surgical etiology, and cardiopulmonary bypass use.
Conclusions:
- Significant changes in constrictive pericarditis etiology were observed over time.
- Long-term survival post-pericardiectomy is influenced by patient-specific factors, including the cause of constriction and symptom severity.
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