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Surgical Pericardiectomy for Constrictive Pericarditis: A Single Tertiary Center Experience
Eyal Nachum1, Leonid Sternik1, Yigal Kassif1
1Department of Cardiac Surgery, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel.
The Thoracic and Cardiovascular Surgeon
|May 28, 2018
Summary
Surgical pericardiectomy (SP) for constrictive pericarditis (CP) shows high safety and efficacy. This study reports favorable short- and long-term outcomes, improving patient functional class and hemodynamics.
Area of Science:
- Cardiology
- Thoracic Surgery
- Cardiac Surgery
Background:
- Constrictive pericarditis (CP) treatment is challenging due to high surgical mortality concerns.
- Surgical pericardiectomy (SP) is the only curative option for CP.
- Tertiary centers aim to evaluate SP outcomes to improve patient referral and management.
Purpose of the Study:
- To report short- and long-term outcomes of surgical pericardiectomy (SP) for constrictive pericarditis (CP).
- To assess the safety and efficacy of SP in a large tertiary center cohort.
- To analyze the impact of concomitant interventions during SP.
Main Methods:
- A retrospective analysis of 55 consecutive patients undergoing SP between 2005 and 2017.
- Comprehensive pre-operative evaluation including echocardiography, CT, and hemodynamic studies.
- Detailed recording of clinical data, surgical techniques, and follow-up outcomes.
Main Results:
- Idiopathic etiology was most common (49%); 60% of patients were in functional class 3/4.
- Complete resection was achieved in 96% of cases, with 7% requiring re-exploration for bleeding.
- Significant improvement in functional class (p<0.001) and reduced right atrial pressures were observed; 22% mortality at mean 52-month follow-up, with only 1 death from right heart failure.
Conclusions:
- Surgical pericardiectomy (SP) demonstrates high safety and favorable clinical efficacy for constrictive pericarditis (CP).
- Outcomes were positive regardless of whether SP was performed alone or with concomitant procedures.
- SP offers significant hemodynamic and functional benefits for CP patients.
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