Constrictive pericarditis: retrospective study of 109 patients

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Mukesh Kumawat1, Tapan Kumar Lahiri1, Damyanti Agarwal1

  • 1Department of Cardiothoracic and Vascular Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Asian Cardiovascular & Thoracic Annals
|April 29, 2018
PubMed

Insights

Chronic constrictive pericarditis, a common diastolic heart disorder, can be effectively treated with pericardiectomy. This surgical procedure, performed via sternotomy or thoracotomy, offers significant improvement in cardiac function.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pericardial Diseases

Background:

  • Chronic constrictive pericarditis is the most frequent diastolic heart disorder, characterized by pericardial non-elasticity and impaired diastolic function.
  • Clinical presentation often mimics right heart failure, with etiology being historically relevant but not definitively diagnostic.
  • Echocardiography and hemodynamic studies are key diagnostic modalities, with pericardial thickness ≥7 mm being highly specific for constrictive features.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of pericardiectomy in patients with chronic constrictive pericarditis.
  • To compare the outcomes of pericardiectomy performed via different surgical approaches.

Main Methods:

  • Retrospective review of data from 109 patients who underwent pericardiectomy between January 1987 and June 2016.
  • Analysis of patient outcomes, including mortality and hemodynamic improvement post-surgery.

Main Results:

  • The study included 109 patients who underwent pericardiectomy, with a low mortality rate of only 2 patients.
  • Pericardiectomy, regardless of surgical approach (mid-sternotomy or anterolateral thoracotomy), demonstrated positive outcomes.

Conclusions:

  • Pericardiectomy is a viable treatment for progressive, fibrotic, and thickened pericardial conditions impairing diastolic filling.
  • While initial results may not be dramatic, continued improvement is expected due to left ventricular dimension enlargement post-surgery.

Keywords:
PericardiectomyPericarditisTreatment outcomeconstrictive

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