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Outcomes and Risk Factors Associated with Pericardiectomy in Patients with Constrictive Pericarditis: A Retrospective
Bin Li1, Chao Dong1, Guangyu Pan1
1Cardiac Surgery Department, Peking University International Hospital, Beijing, China.
Insights
Pericardiectomy offers optimal mid-term outcomes for constrictive pericarditis, though moderate mitral insufficiency and partial procedures increase mortality risk. This study details outcomes and risk factors for this definitive treatment.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Outcomes Research
Background:
- Constrictive pericarditis requires pericardiectomy, a definitive treatment with known risks.
- Limited data exists on mid-term outcomes and risk factors associated with pericardiectomy.
Purpose of the Study:
- To report mid-term outcomes of pericardiectomy for constrictive pericarditis.
- To identify risk factors influencing mortality after pericardiectomy.
Main Methods:
- Retrospective review of 86 patients undergoing pericardiectomy from April 2018 to January 2023.
- Analysis of patient demographics, surgical details, etiologies, and outcomes.
Main Results:
- The 5-year survival rate was 83.5%.
- Preoperative moderate mitral insufficiency and partial pericardiectomy were significant predictors of increased 5-year mortality.
- The 30-day mortality rate was 5.8%.
Conclusions:
- Pericardiectomy is a safe procedure for constrictive pericarditis.
- Optimal mid-term outcomes can be achieved with careful patient selection and surgical approach.
Purpose:
Pericardiectomy is the definitive treatment option for constrictive pericarditis and is associated with a high prevalence of morbidity and mortality. However, information on the associated outcomes and risk factors is limited. We aimed to report the mid-term outcomes of pericardiectomy from a single center in China.
Methods:
We retrospectively reviewed data collected from patients who underwent pericardiectomy at our institute from April 2018 to January 2023.
Results:
Eighty-six consecutive patients (average age, 46.1 ± 14.7 years; 68.6 men) underwent pericardiectomy through midline sternotomy. The most common etiology was idiopathic (n = 60, 69.8%), and 82 patients (95.3%) were in the New York Heart Association function class III/IV. In all, 32 (37.2%) patients underwent redo sternotomies, 36 (41.9%) underwent a concomitant procedure, and 39 (45.3%) required cardiopulmonary bypass. The 30-day mortality rate was 5.8%, and the 1-year and 5-year survival rates were 88.3% and 83.5%, respectively. Multivariable analysis revealed that preoperative mitral insufficiency (MI) ≥moderate (hazard ratio [HR], 6.435; 95% confidence interval [CI] [1.655-25.009]; p = 0.007) and partial pericardiectomy (HR, 11.410; 95% CI [3.052-42.663]; p = 0.000) were associated with increased 5-year mortality.
Conclusion:
Pericardiectomy remains a safe operation for constrictive pericarditis with optimal mid-term outcomes.
