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Chronic constrictive pericarditis: hemodynamic changes following pericardiectomy

O A Adebo, S A Adebonojo, O Osinowo

    Journal of the National Medical Association
    |May 1, 1980
    PubMed
    Summary

    Intraoperative pressure monitoring during pericardiectomy for constrictive pericarditis can identify patients at risk of poor outcomes. Normalizing right atrial pressure post-surgery indicates reversible myocardial dysfunction and better survival.

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    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Thoracic Surgery

    Background:

    • Constrictive pericarditis is a serious condition requiring surgical intervention.
    • Pericardiectomy aims to relieve cardiac compression and improve hemodynamics.
    • Predicting postoperative outcomes in these patients remains a clinical challenge.

    Purpose of the Study:

    • To evaluate the utility of intraoperative pressure measurements in predicting outcomes after pericardiectomy for constrictive pericarditis.
    • To identify hemodynamic parameters associated with mortality and morbidity.

    Main Methods:

    • Ten patients with chronic constrictive pericarditis underwent pericardiectomy.
    • Right heart catheterization and angiocardiography were performed preoperatively in seven patients.

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  • Intraoperative and immediate postoperative pressures were monitored.

    • Main Results:

    • A significant decline in mean right atrial pressure was observed immediately after decortication.
    • Two patient groups emerged postoperatively: normal pressures (4 patients, no mortality) and abnormal pressures (5 patients, 3 deaths).
    • Restoration of normal pressure was not dependent on disease duration.

    Conclusions:

    • Intraoperative pressure measurement is a valuable parameter for identifying patients with reversible myocardial dysfunction at risk of refractory cardiac failure.
    • Achieving normal postoperative pressures is crucial for improved survival after pericardiectomy.