US National Trends in the Management and Outcomes of Constrictive Pericarditis: 2005-2014

Mori, Makoto; Mullan, Clancy; Mahmood, Syed Usman Bin; Yousef, Sameh; Pelletier, Keith J.; Mangi, Abeel A.; Geirsson, Arnar

doi:10.1016/j.cjca.2019.05.015

Cited by 23 publications

(26 citation statements)

References 17 publications

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“…In fact, the incidence of CP in the 2 years following any cardiac surgical procedure is approximately 0.2–0.4% [ 4 ]. In developing countries, tuberculosis (TB), often associated with concomitant Human Immunodeficiency Virus (HIV) infection, is the leading cause of pericarditis and estimated to be the etiology in 22 to 91% of cases [ 9 , 11 , 13 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Fifteen-year experience with pericardiectomy at a tertiary referral center

Faiza

Prakash

Namburi

et al. 2021

J Cardiothorac Surg

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Purpose Pericardiectomy has traditionally carried relatively high perioperative mortality and morbidity, with few published reports of intermediate- and long- term outcomes. We investigated our 15-year experience performing pericardiectomy at our institution. Methods Retrospective study of all patients who underwent pericardiectomy at our institution between 2005 and 2019. Baseline demographics, intraoperative details, and postoperative outcomes including long-term survival were analyzed. Results Sixty-three patients were included in the study. 66.7% of subjects underwent isolated pericardiectomy while 33.3% underwent pericardiectomy concomitantly with another cardiac surgical procedure. The most common indications for pericardiectomy were constrictive (79.4%) and hemorrhagic (9.5%) pericarditis. Preoperatively, 76.2% of patients were New York Heart Association class II and III, while postoperatively, 71.4% were class I and II. One-, three-, five-, and ten- year overall mortality was 9.5, 14.3, 20.6, and 25.4%, respectively. Overall pericarditis recurrence rate was 4.8%. Conclusion Pericardiectomy carries relatively high overall mortality rates, which likely reflects underlying disease etiology and comorbidities. Patients with prior cardiac intervention, history of dialysis, and immunocompromised state are associated with worse outcomes.

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Section: Introductionmentioning

confidence: 99%

Fifteen-year experience with pericardiectomy at a tertiary referral center

Faiza

Prakash

Namburi

et al. 2021

J Cardiothorac Surg

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“…Non-steroidal anti-inflammatory agents or colchicine are considered to be first-line therapies, but up to 16% of patients continue to have symptoms and eventually require extensive pericardiectomy. 8 …”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of effusive–constrictive pericarditis: a case report

Al-Saiegh

Spears

Barry

et al. 2021

European Heart Journal - Case Reports

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Background Effusive–constrictive pericarditis (ECP) is a rare syndrome involving pericardial effusion and concomitant constrictive pericarditis. The hallmark is a persistently elevated right atrial pressure of >10 mmHg or reduction of less than 50% from baseline despite pericardiocentesis. Aetiologies include radiation, infection, malignancy, and autoimmune disease. Case summary A 71-year-old man with a history of atrial fibrillation, obesity, hypertension, obstructive sleep apnoea, managed with continuous positive airway pressure presented with acute pericarditis complicated by pericardial effusion leading to cardiac tamponade. He was diagnosed with ECP after pericardiocentesis and was managed surgically with a pericardial window. Discussion Early detected cases of ECP can be managed by medical therapy. Therapeutic interventions include pericardiocentesis, balloon pericardiostomy, and pericardiectomy. This report describes a case of new-onset congestive heart failure secondary to ECP.

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“…Typical symptoms and signs are a prominent change in the x and y descent in jugular venous pulse, dyspnea upon exertion, palpitations, abdominal distension, as well as edema in the ankles or legs. Echocardiography revealed a severely thickened or calcified pericardium and cardiac catheterization revealed elevated end-diastolic pressure and the "square root sign" of right ventricular pressure tracing [Epting 2016;Mori 2019;Calderon-Rojas 2020]. Preoperative pericardial effusion was diagnosed by chest computed tomographic (CT) scan, transthoracic echocardiography, and intraoperative confirmation.…”

Section: Study Populationmentioning

confidence: 99%

Preoperative Pericardial Effusion is Associated with Low Cardiac Output Syndrome After Pericardiectomy for Constrictive Pericarditis

Wen

et al. 2021

HSF

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Background: Low cardiac output syndrome is the main cause of death after pericardiectomy. Methods: Patients who underwent pericardiectomy for constrictive pericarditis from January 2009 to October 2020 at our hospital were included in the study. Histopathologic studies of pericardium tissue from every patient were performed. All survivors were followed up. Results: Ninety-two consecutive patients underdoing pericardiectomy were included in the study. The incidence of postoperative low cardiac output syndrome was 10.7% (10/92). There were five operative deaths. Mortality and incidence of LCOS in the group with pericardial effusion were significantly higher than those in the group without pericardial effusion. Tuberculosis of the pericardium (60/92, 65.2%) was the most common histopathologic finding in this study. Both univariate and multivariate analyses showed that preoperative pericardial effusion is associated with increased rate of low cardiac output syndrome. Eighty-five survivors were in NYHA class I (85/87, 97.7%), and two were in class II (2/87, 2.3%) at the latest follow up. Conclusions: Preoperative pericardial effusion is associated with low cardiac output syndrome after pericardiectomy. Tuberculosis of the pericardium was the most common histopathologic finding in this study. For constrictive pericarditis caused by tuberculous bacteria, systematic antituberculosis drugs should be given. Preoperative pericardial effusion is associated with increased rate of low cardiac output syndrome. Perfect preoperative preparation is very important to reduce the incidence of postoperative low cardiac output syndrome and mortality. It is very important to use a large dose of diuretics with cardiotonic or vasopressor in a short time after the operation.

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US National Trends in the Management and Outcomes of Constrictive Pericarditis: 2005-2014

Cited by 23 publications

References 17 publications

Fifteen-year experience with pericardiectomy at a tertiary referral center

Fifteen-year experience with pericardiectomy at a tertiary referral center

Diagnosis and treatment of effusive–constrictive pericarditis: a case report

Preoperative Pericardial Effusion is Associated with Low Cardiac Output Syndrome After Pericardiectomy for Constrictive Pericarditis

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