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Pericardectomy for chronic constrictive pericarditis: risks and outcome

T Tirilomis1, S Unverdorben, J von der Emde

  • 1Department of Cardiac Surgery, University Hospital, Erlangen, Germany.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1994
PubMed
Summary

Pericardectomy for constrictive pericarditis offers long-term survival, with improved functional status post-surgery. Preoperative NYHA class IV and specific clinical factors predict poorer outcomes.

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Area of Science:

  • Cardiology
  • Thoracic Surgery

Background:

  • Chronic constrictive pericarditis significantly impacts cardiac function and patient quality of life.
  • Pericardectomy is a surgical option for managing this condition.

Purpose of the Study:

  • To evaluate the long-term outcomes and survival rates following pericardectomy for chronic constrictive pericarditis.
  • To identify preoperative predictors of mortality and morbidity.

Main Methods:

  • A retrospective analysis of 71 consecutive patients undergoing pericardectomy between 1970 and 1990.
  • Data collection included preoperative New York Heart Association (NYHA) classification, operative approach, early mortality, and long-term follow-up (average 11 years).

Main Results:

  • Early mortality was 5.6%, with all early deaths occurring in female patients classified as NYHA class IV preoperatively.

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  • Actuarial survival rates at 20 years were 65.8%.
  • Negative predictors for survival included preoperative NYHA class IV, low-voltage ECG, ascites, dyspnea at rest, and hyperbilirubinemia.

    • Conclusions:

    • Pericardectomy can lead to significant long-term survival and improved functional capacity in patients with chronic constrictive pericarditis.
    • Identifying high-risk patients preoperatively is crucial for optimizing surgical outcomes.