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Radical pericardiectomy for pericardial diseases

Gabriele M Iacona1, Shinya Unai1, Douglas R Johnston1

  • 1Heart Vascular & Thoracic Institute, Cleveland Clinic, OH, USA.

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|November 24, 2021
PubMed

Insights

Pericardiectomy, the surgical removal of the pericardium, is indicated for severe, refractory pericarditis and chronic constrictive pericarditis. The primary surgical goal is complete inflammation removal for improved patient outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Pericarditis, the most common pericardial disease, often goes undiagnosed.
  • Surgical indications for pericardiectomy stem from inflammatory/relapsing and constrictive pericarditis.
  • Radical pericardiectomy aims for complete inflammation removal.

Discussion:

  • Surgical decisions for pericarditis balance symptom severity and treatment response.
  • Pericardiectomy is standard for chronic constrictive pericarditis (NYHA class III-IV).
  • Guidelines support pericardiectomy for persistent, symptomatic cases.

Key Insights:

  • Pericardiectomy offers a definitive treatment for debilitating pericarditis.
  • Complete pericardial removal is crucial for addressing inflammation.
  • Surgical intervention is considered when medical management fails.

Outlook:

  • Further research may clarify incidence and diagnostic challenges.
  • Optimizing surgical timing and technique can improve outcomes.
  • Understanding the interplay between pericarditis types is key.

Keywords:
Constrictive pericarditisInflammatory pericarditisRadical pericardiectomyRelapsing pericarditis

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