Related Experiment Video

Updated: Jul 27, 2025

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

3.5K

Diagnosis and surgical management of pericardial constriction after cardiac surgery

Alejandra Castro-Varela1, Hartzell V Schaff1, Jae K Oh2

  • 1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.

The Journal of Thoracic and Cardiovascular Surgery
|June 9, 2023
PubMed

Insights

Constrictive pericarditis after cardiac surgery often presents with right heart failure. Urgent pericardiectomy following initial surgery is linked to worse long-term survival for these patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Thoracic Surgery

Background:

  • Previous cardiac surgery is a growing cause of constrictive pericarditis.
  • Data on the clinical presentation and outcomes of surgical treatment for this condition are limited.

Purpose of the Study:

  • To analyze the clinical presentation and outcomes of pericardiectomy in patients with constrictive pericarditis following cardiac surgery.

Main Methods:

  • A retrospective review of 263 patients who underwent pericardiectomy for postoperative constriction between January 1, 1993, and July 1, 2017.
  • Outcomes assessed included early and late mortality, and clinical presentation features.

Main Results:

  • Median age was 64 years; median interval to pericardiectomy was 2.7 years.
  • Common prior surgeries included coronary artery bypass grafting (43%) and valve surgery (32%).
  • Right heart failure symptoms (84%) were the most common presentation; 5.5% had early mortality, with 5- and 10-year survival rates of 61% and 44%, respectively. Older age, diabetes, and nonelective pericardiectomy within 2 years of initial surgery were associated with decreased survival.

Conclusions:

  • Pericardial constriction post-cardiac surgery can manifest at any time interval.
  • Right heart failure symptoms in patients with prior cardiac surgery warrant consideration for constrictive pericarditis.
  • Urgent pericardiectomy after cardiac surgery is associated with poor long-term outcomes.
Abstract

Keywords:
constrictive pericarditispericardiectomypostcardiac surgeryright heart-failure

More Related Videos

O-Ring Aortic Banding Versus Traditional Transverse Aortic Constriction for Modeling Pressure Overload-Induced Cardiac Hypertrophy09:24

O-Ring Aortic Banding Versus Traditional Transverse Aortic Constriction for Modeling Pressure Overload-Induced Cardiac Hypertrophy

Published on: October 6, 2022

3.6K
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

3.8K

Related Concept Videos

Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
16
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
14
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
18
Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
12
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
21
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16