Surgical Treatment of Constrictive Pericarditis

Depboylu, Burak Can; Mootoosamy, Parmeseeven; Vistarini, Nicola; Testuz, Ariane; El-Hamamsy, Ismaı̈l; Çıkırıkçıoğlu, Mustafa

doi:10.14503/thij-16-5772

Cited by 69 publications

(93 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Complete pericardiectomy has been proven to be not only associated with lower perioperative mortality [9] but also confer significant long-term survival benefit and clinical functional improvement [10,18] . Generally, pericardiectomy can be performed through either median sternotomy or left anterolateral thoracotomy, while median sternotomy provides adequate exposure of the right atrium, right ventricle and the vena cava, thus enabling extensive pericardial resection [19] .…”

Section: Discussionmentioning

confidence: 99%

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

Fang

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose The risk factors of postoperative outcomes after pericardiectomy in tuberculous constrictive pericarditis have still been unclear. This study aimed to investigate the predictors of postoperative complication and prolonged intensive care unit (ICU) stay in the patients with tuberculous constrictive pericarditis undergoing pericardiectomy. Methods A total of 88 patients with tuberculous constrictive pericarditis undergoing pericardiectomy were retrospectively enrolled. Logistic regression and Cox regression analysis were performed to identify the predictors of postoperative complication and prolonged ICU stay, respectively. Results All patients underwent complete pericardiectomy and 35 (39.8%) had postoperative complications with no mortality within 30 days after surgery. Postoperative complication delayed postoperative ICU stay (P < 0.001), duration of chest drainage (P < 0.001) and postoperative hospital stay (P < 0.001). Preoperative NYHA functional class (P = 0.004, OR 4.051, 95%CI 1.558–10.533) and preoperative central venous pressure (CVP) (P = 0.031, OR 1.151, 95%CI 1.013–1.309) were independent risk factors of postoperative complication. Postoperative complication (P < 0.001, HR 4.132, 95%CI 2.217–7.692) was the independent risk factor for prolonged ICU stay. Conclusion Complete pericardiectomy was associated with high risk of postoperative complication in tuberculous constrictive pericarditis. Poor preoperative NYHA functional class and high preoperative CVP were shown to predict postoperative complication which was the predictor of prolonged ICU stay.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

Fang

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Constrictive pericarditis is a progressive course which is associated with pericardial fibrosis with or without calcification and incomplete ventricular filling, which causes congestion and reduces cardiac output. 15,16 One of the most common causes of constrictive pericarditis is the history of previous cardiac surgery. After pericardiotomy, temporary loss of pericardial elasticity results in formation of pericardial effusion, fibrin deposition, and inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…After pericardiotomy, temporary loss of pericardial elasticity results in formation of pericardial effusion, fibrin deposition, and inflammation. 16 Generally, constrictive physiology will develop between 5 and 30 days after the surgery. 4 In most patients, pericardial effusion will be absorbed and inflammation will be reduced; but in some patients, pericardial inflammation persists and leads to pericardial fibrosis and calcification, which becomes constrictive pericarditis.…”

Section: Discussionmentioning

confidence: 99%

The effect of colchicine on the echocardiographic constrictive physiology after coronary artery bypass graft surgery

et al. 2020

View full text Add to dashboard Cite

Background Constrictive physiology is a transitory condition that could lead to constrictive pericarditis, which is a rare complication after open‐heart surgery. Anti‐inflammatory drugs like colchicine are recommended for prevention of constrictive pericarditis; however, there is no evidence about the effect of colchicine on constrictive pericarditis. Thus, the aim of this study is to evaluate the preventive effect of colchicine on the incidence of echocardiographic constrictive physiology after open‐heart surgery. Methods This was a parallel randomized, double‐blind trial. Patients were randomly assigned to receive 1 mg colchicine once‐daily from 48 hours before and 0.5 mg twice daily for 5 days after surgery. Primary outcome was the incidence of the constrictive physiology after primary endpoint (1 week after the surgery). The secondary outcome was the primary outcome after secondary endpoint (4 weeks after surgery) plus the new cases of constrictive physiology between the primary and secondary endpoints. Results Out of 160 participating patients, the primary outcome occurred in 19 patients (23%) in placebo and 11 (13%) in intervention groups. There was no significant difference between two groups (P = .106). After 4 weeks of follow‐up, 19 patients (23%) in placebo and 9 (11%) in intervention groups had constrictive physiology whereas 2 out of 11 patients (18.2%) were recovered. The difference was significant (P = .038). No new case of constrictive physiology occurred between primary and secondary endpoints. Conclusion Short‐term use of colchicine has a preventive effect on reducing constrictive physiology after 1 month of open‐heart surgery but not a week after that.

show abstract

“…Surgical treatment includes drainage of pericardial fluid in effusive pericarditis and removal of thickened pericardium from the surface of the heart and the great vessels including the aorta, pulmonary artery and the vena cavas 21 . Pericardiectomy is defined as the removal of a portion or all of the pericardium, this procedure is commonly indicated for constrictive pericarditis 22 .…”

Section: Introductionmentioning

confidence: 99%

Early operative outcome of pericardiectomy for symptomatic chronic tuberculous constrictive pericarditis

Jan¹,

Imran²,

Aqeel³

et al. 2019

Int. j. endorsing health sci. res.

View full text Add to dashboard Cite

Background: Pericardiectomy procedure is commonly indicated for constrictive pericarditis (CP). One of the most important clue to diagnosis of CP is the signs and symptoms of right-sided heart failure that are not completely explained by presence of pulmonary disease or left-ventricular failure. The aim of this study was to assess clinical data presentation and early operative outcomes of pericardiectomy performed for symptomatic chronic constrictive pericarditis who had failed maximal medical therapy. Methodology: A retrospective analysis was carried out of consecutive constrictive pericarditis adult age patients who underwent pericardiectomy procedure from 2002 to 2012. The patients who had intraoperative diagnosis of other then constrictive pericarditis were excluded from further analysis. A total 51 patients were selected for this study. The preoperative assessment, intraoperative findings and postoperative course and outcome such as hospital stay, prolonge ICU stay, post-operative CPV etc. were evaluated. Results: 43 males and 8 females were include in the study among them 41% gave history of previous (TB) and 35% were pediatric patients (teens, as shown less than 19 years). 8 patients had effusive type pericarditis. The preoperative findings revealed dyspnea 54%, Chest Pain 45% and persistent cough 31%. Furthermore, 43% patients had ascites and 41% with pleural effusion. The mean preoperative central venous pressure (CVP) was 20.5 respectively. The post-operative outcome was short hospital stay, the post-operative patients CVP was estimated 13.5 and the mean drop of CVP due to pericardiectomy was estimated 7 respectively. Conclusion: The conclusive findings of our study revealed that among the patients of symptomatic chronic tuberculous CP, the timely pericardiectomy attempt can effectively improve the hemodynamics of the patient. The early pericardiectomy can also reduce the morbidity and mortality rate of these patients.

show abstract

Surgical Treatment of Constrictive Pericarditis

Cited by 69 publications

References 20 publications

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

The effect of colchicine on the echocardiographic constrictive physiology after coronary artery bypass graft surgery

Early operative outcome of pericardiectomy for symptomatic chronic tuberculous constrictive pericarditis

Contact Info

Product

Resources

About