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Long-term results of radical pericardiectomy for constrictive pericarditis in Korean population

Min Suk Choi1,2, Dong Seop Jeong3, Jae K Oh4,5

  • 1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Journal of Cardiothoracic Surgery
|February 8, 2019
PubMed

Insights

Radical pericardiectomy offers superior long-term survival and functional recovery in constrictive pericarditis compared to conventional methods. This approach improves right ventricular function and reduces tricuspid regurgitation over time.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Cardiac Surgery

Background:

  • The extent of pericardiectomy is crucial in managing constrictive pericarditis, yet its long-term impact remains understudied.
  • This study compares the long-term outcomes of radical pericardiectomy versus conventional phrenic-to-phrenic pericardiectomy.

Purpose of the Study:

  • To evaluate the long-term efficacy and safety of radical pericardiectomy compared to conventional pericardiectomy.
  • To identify factors influencing long-term mortality in patients undergoing pericardiectomy.

Main Methods:

  • Retrospective review of 90 patients undergoing pericardiectomy between February 1995 and April 2015.
  • Patients were categorized into conventional (n=37) and radical (n=53) groups based on surgical extent.
  • Long-term follow-up data on survival, functional class, and echocardiographic parameters were collected.

Main Results:

  • Radical pericardiectomy demonstrated a significantly higher survival rate (74.7% vs. 50.4% at 20 years) and better New York Heart Association (NYHA) class recovery.
  • Early mortality occurred only in the conventional group (4.4%) due to low cardiac output syndrome.
  • Conventional pericardiectomy, redosternotomy, and high-grade tricuspid regurgitation were associated with increased late mortality.

Conclusions:

  • Radical pericardiectomy leads to improved right ventricular systolic pressure and reduced tricuspid regurgitation progression over time.
  • Conventional pericardiectomy is linked to higher long-term mortality, underscoring the benefits of a more extensive surgical approach.
  • Preoperative tricuspid regurgitation severity is a critical predictor of long-term outcomes.
Abstract

Keywords:
Constrictive pericarditisPericardiectomy

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