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[Early and late results of pericardiectomy for constrictive pericarditis]
11st Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Insights
This study on constrictive pericarditis surgery found that a median sternotomy approach without cardiopulmonary bypass yielded good long-term cardiac function and survival. Early diagnosis and surgical intervention are emphasized for better outcomes.
Area of Science:
- Cardiology
- Thoracic Surgery
- Cardiac Surgery
Background:
- Constrictive pericarditis significantly impairs cardiac function.
- Surgical intervention is often necessary for severe cases.
Purpose of the Study:
- To evaluate the efficacy and long-term outcomes of surgical treatment for constrictive pericarditis using a specific surgical approach.
- To assess hemodynamic improvements and survival rates post-surgery.
Main Methods:
- Retrospective review of seven patients undergoing pericardiectomy.
- Median sternotomy approach without cardiopulmonary bypass.
- Pericardial flap excision anterior to phrenic nerves.
Main Results:
- Significant improvement in cardiac index (2.30 to 3.30 l/min/m2).
- Operative mortality was 28.6% (2/7 patients).
- Long-term survival ranged from 3 to 13 years, with most patients in New York Heart Association Class 1 or 2.
Conclusions:
- The described surgical method offers good cardiac functional results and favorable long-term outcomes.
- Early diagnosis and prompt surgical intervention are crucial for managing constrictive pericarditis effectively.
Abstract:
Seven patients (4 males and 3 females: age 1 to 71 years old) who underwent operations for constrictive pericarditis from 1980 were reviewed. The median sternotomy approach was used without cardiopulmonary bypass. The pericardial flap was excised just anterior to both phrenic nerves. The postoperative hemodynamic improvement was good, especially in cardiac index (from 2.30 to 3.30 l/min/m2). Two patients were operative death. One was metastasis to pericardium from gastric cancer and another was multiple organ failure due to sepsis. Long-term survival was 3 to 13 years. One patient was dead at nine years after operation. Others were in New York Heart Association Class 1 or 2 in the long-term period after surgery. We conclude that our method can lead to good cardiac functional results and long-term good results. Our report wishes to emphasize early diagnosis and operation.