Ten Years Experience with Pericardiectomy

Abstract

A retrospective analysis was made of the records of 62 patients who underwent pericardiectomy over a ten year period (1985 to 1996) in our department. Primarily, 43 patients (69.4%) had tuberculosis, 16 patients (25.8%) were diagnosed as idiopathic or viral infection, 2 patients (3.2%) had a previous cardiac operation and 1 patient (1.6%) had a neoplasm. Eight patients were in New York Heart Association functional class I, 22 in class II, 24 in class III, and 8 in class IV. Pericardiectomy was performed through midline sternotomy in all cases; 2 required cardiopulmonary bypass. Subtotal pericardiectomy was performed, in which the phrenic nerves define the posterior extent of pericardial resection. Low cardiac output was present in 8 patients. The early mortality rate was 6.45% (4 patients). During the follow-up period, ranging from 1 to 7 years (mean 3.8 ± 1.42 years), there were 2 late deaths due to the right heart failure. One patient who underwent pericardiectomy after an open-heart operation showed recurrent pericardial constriction. We conclude that pericardiectomy using midline sternotomy with or without cardiopulmonary bypass can be performed with low mortality and can result in good long-term survival and improved functional capacity.

Surgical experience on chronic constrictive pericarditis in African setting: review of 35 years’ experience in Cote d’Ivoire

“…Other authors have reported similar results (10,12,(18)(19)(20)(21)(22); Merle et al (3) in their short series of four patients mentioned one early death. The most frequent cause of early death was a low cardiac output (1,13), which corresponds to our observation.…”

“…The commonest symptoms described in the literature (13,14) with a frequency of 90% to 98% are similar to the ones we found: hepatomegaly, raised jugular venous pressure. Ascites and peripheral edemas are less frequent (50% to 80%) (13).…”

“…Several surgical approaches are suggested: left anterolateral thoracotomy, bilateral anterior thoracotomy and median sternotomy (1,2,13,14).…”

Surgical Treatment of Chronic Constrictive Pericarditis in a Developing Country

“…Secondary death by myocardial decay is due to inflammatory phenomena secondary to epicardial injury [25]. The most common cause of early death was low cardiac output [26], which is consistent with our observation. Surgical removal of the pericardium is associated with an operative mortality rate of 5% to 20% in various large series.…”