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Pericardiectomy for constrictive pericarditis: short- and long-term outcomes in Sweden

Sebastian Sartipy1, Susanne J Nielsen1,2, Carl Johan Malm1,2

  • 1Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

Scandinavian Cardiovascular Journal : SCJ
|July 16, 2026
PubMed

Insights

Pericardiectomy for constrictive pericarditis has a 5.1% 30-day mortality, with older age a risk factor. While long-term survival is poorer than the general population, comorbidities significantly influence outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Thoracic Surgery

Background:

  • Constrictive pericarditis, caused by pericardial fibrosis, restricts diastolic relaxation and can lead to heart failure.
  • Pericardiectomy is the only curative treatment for constrictive pericarditis.
  • Limited evidence exists on factors influencing outcomes after pericardiectomy.

Purpose of the Study:

  • To investigate short- and long-term outcomes following pericardiectomy for constrictive pericarditis.
  • To identify factors associated with variations in outcomes after this procedure.

Main Methods:

  • A nationwide Swedish study of all pericardiectomy procedures for constrictive pericarditis between 1997 and 2020.
  • Data sourced from the SWEDEHEART registry and two mandatory registries.
  • Analysis of short- and long-term survival, with comparison to an age- and sex-matched general population control group.

Main Results:

  • 175 patients (mean age 59 years) were included; 47% required extracorporeal circulation, and 26% had concomitant cardiac surgery.
  • 30-day mortality was 5.1%, linked to older age at surgery (p=0.008).
  • 22% of patients were readmitted for heart failure, associated with older age (p=0.02) and preoperative atrial fibrillation (p<0.001).
  • Univariable analysis showed poorer long-term survival in pericardiectomy patients versus controls (HR 2.55), but this was attenuated after multivariable adjustment (aHR 1.40).

Conclusions:

  • Pericardiectomy for constrictive pericarditis is a rare procedure with a notable early mortality risk.
  • A low proportion of patients experience heart failure readmission post-surgery.
  • Preoperative comorbidities significantly impact postoperative outcomes in patients undergoing pericardiectomy.
Abstract

Keywords:
Constrictive pericarditisheart failurelong-term survivalopen heart surgerypericardiectomy

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