Total pericardectomy for chronic constrictive pericarditis. Early and late results

The early and late results of total pericardiectomy, performed over a 17 years period in 39 patients with chronic constrictive pericarditis, are presented. The overall operative mortality was 18%. With growing surgical experience and anesthesiological improvement, the operative morality of 26% during the first 12 years decreased to an acceptable 6.2% during the last 5 years. The cumulative 5 and 10 years survival rates were respectively 73% and 68%. Ninety-three percent of the surviving patients were classified in functional class I or II (NYHA classification), while preoperatively 90% of these cases belonged to class III or IV. Viewing these results it is concluded that the tendency towards early surgery should be encouraged, especially because the chronic state is accompanied by several deleterious effects.