Pericardiectomy After Previous Bypass Grafting: Analyzing Risk and Effectiveness in this Rare Clinical Entity

Abstract

The rate of early mortality for pericardiectomy after previous coronary bypass grafting is low, and the late adverse impact of cardiopulmonary bypass likely reflects increased severity of disease and technical complexity. Importantly, during late follow-up extending more than 17 years, the vast majority of patients demonstrated significant improvement in NYHA functional class.

Radical pericardiectomy for chronic constrictive pericarditis

“…These overall survival rates compare well to several contemporary published series with CCP . Overall 5‐year survival rate in patients with idiopathic CCP was 78% and for the secondary post‐surgical CCP 67% and these data also compare favorably to several contemporary series with CCP …”

Experience With Pericardiectomy for Constrictive Pericarditis Over Eight Decades

“…In our series, 30-day mortality in the historical era was 13.5%, whereas it decreased to 5.2% in the contemporary era. Isolated pericardiectomy for idiopathic constrictive pericarditis has a very low risk of early death, and early mortality of pericardiectomy after coronary artery bypass surgery is acceptably low, at 3% [28]. Thus, although continued advances in perioperative support may improve this relatively low perioperative risk [29], survival of patients after operation is poorer than expected.…”

Fifteen-year experience with pericardiectomy at a tertiary referral center

“…It is estimated that about 20% of patients diagnosed with CP ultimately undergo pericardiectomy [9][10][11][12]. In developed countries, the cause of pericarditis is unclear, although a history of viral infections, prior cardiac surgeries and mediastinal radiation are reported to be predisposing factors [2,10,[13][14][15]. In fact, the incidence of CP in the 2 years following any cardiac surgical procedure is approximately 0.2-0.4% [4].…”