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Pericardiectomy for Constrictive and Recurrent Pericarditis: State of the Art Update

Kristina Krzelj1, Maria Bakaeen1, Tom Kai Ming Wang2

  • 1Department of Thoracic and Cardiovascular Surgery, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.

Current Cardiology Reports
|January 22, 2026
PubMed

Insights

Radical or complete pericardiectomy is recommended over partial resection for constrictive and recurrent pericarditis to prevent symptom recurrence. Advanced imaging and cardiopulmonary bypass aid surgical planning and execution for better outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Pericardial Disease

Background:

  • Constrictive and recurrent pericarditis pose significant clinical challenges.
  • Surgical management, particularly pericardiectomy, is crucial for improving patient outcomes.

Purpose of the Study:

  • To offer a contemporary surgical perspective on managing constrictive and recurrent pericarditis.
  • To review current diagnostic and therapeutic strategies for pericardiectomy.

Main Methods:

  • Review of current literature on surgical approaches to pericarditis.
  • Analysis of diagnostic modalities including cardiac MRI, echocardiography, and heart catheterization.
  • Evaluation of different pericardiectomy techniques (partial vs. radical/complete).

Main Results:

  • Radical or complete pericardiectomy via median sternotomy is preferred over partial resection to minimize recurrence risk.
  • Cardiopulmonary bypass can enhance the safety and completeness of pericardiectomy.
  • Intraoperative challenges include low cardiac output syndrome, tricuspid regurgitation, and coronary injury.
  • A multidisciplinary approach in experienced centers is vital for optimal results.

Conclusions:

  • Complete pericardiectomy is advised over partial to prevent symptom or constriction recurrence.
  • Further research is needed to determine the optimal timing and extent of pericardiectomy.
Abstract

Keywords:
Cardiopulmonary bypassConstrictive pericarditisPericardiectomyRecurrent pericarditis

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