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Surgical Treatment of Constrictive Pericarditis

Brunella Bertazzo1, Alejandro Cicolini1, Martin Fanilla2

  • 1Favaloro Foundation University Hospital Department of Cardiac Surgery Intensive Care Buenos Aires Argentina Department of Cardiac Surgery Intensive Care, Favaloro Foundation University Hospital, Buenos Aires, Argentina.

Brazilian Journal of Cardiovascular Surgery
|January 24, 2023
PubMed

Insights

Pericardiectomy for constrictive pericarditis shows significant benefits, especially for patients with preserved functional class. Early intervention is recommended to improve outcomes and reduce prolonged hospital stays.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Internal Medicine

Background:

  • Constrictive pericarditis treatment primarily involves pericardiectomy.
  • Surgery carries risks of high early morbidity, mortality, and limited long-term survival.

Purpose of the Study:

  • To describe the outcomes of pericardiectomies performed over a 30-year period.
  • To identify factors associated with prolonged hospitalization and mortality after pericardiectomy.

Main Methods:

  • A retrospective, observational study of 45 pericardiectomies performed between 1992 and 2022.
  • Analysis of patient demographics, preoperative conditions, and surgical outcomes.

Main Results:

  • Idiopathic constrictive pericarditis was most common (46.6%).
  • Advanced functional class, persistent pleural effusion, and symptom onset >6 months were linked to prolonged hospitalization.
  • In-hospital and 30-day mortality rates were 6.6% and 8.8%, respectively.
  • Patients with preserved functional class had a 17-fold increased likelihood of symptom improvement.

Conclusions:

  • Advanced functional class and delayed symptom onset (>6 months) are poor prognostic indicators for pericardiectomy.
  • Early surgical intervention is strongly supported to improve patient outcomes and reduce hospitalization duration.
Abstract

Keywords:
Chronic Pericarditis.Constrictive PericarditisPericardial DiseasePericardiectomy

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