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Our experience of total pericardiectomy for constrictive pericarditis: a comprehensive analysis over a period of 5

Manish Jadhao1, Kuntal Surana1, Vijay Shewale1

  • 1Department of Cardiovascular and Thoracic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.

Kardiochirurgia I Torakochirurgia Polska = Polish Journal of Cardio-Thoracic Surgery
|February 8, 2021
PubMed

Insights

Surgical pericardiectomy offers favorable short-term outcomes for constrictive pericarditis (CP), improving functional class in most survivors despite some operative mortality.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Internal Medicine

Background:

  • Constrictive pericarditis (CP) results from pericardial thickening and calcification, reducing cardiac output.
  • Surgical pericardiectomy is a key treatment for CP, despite limited comparative studies.

Purpose of the Study:

  • To identify predictors of morbidity and mortality associated with pericardiectomy.
  • To evaluate the short-term surgical outcomes of pericardiectomy for CP in a single center.

Main Methods:

  • Retrospective analysis of 30 patients undergoing isolated pericardiectomy (2013-2018).
  • Procedures involved median sternotomy and total pericardiectomy without cardiopulmonary bypass.
  • Pre-, intra-, and post-operative data were collected and analyzed.

Main Results:

  • 60% of patients were male; 15 had a history of tuberculosis.
  • Most patients presented with NYHA class III/IV; preoperative CVP decreased significantly post-surgery.
  • 30-day mortality was 6.66%; low-cardiac output syndrome was the main morbidity. 26 patients showed improved NYHA status.

Conclusions:

  • Pericardiectomy for CP has associated operative mortality but yields favorable short-term results.
  • The surgery significantly improves functional class in the majority of surviving patients.
Abstract

Keywords:
constrictive pericarditispericardiectomytuberculous pericarditis

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