What question did this study set out to answer?

To evaluate the clinical, pathological, and surgical features of constrictive pericarditis in patients presenting with normal histopathological pericardial thickness.

September 30, 2003Circulation

Constrictive Pericarditis in 26 Patients With Histologically Normal Pericardial Thickness

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Why the study?

Does normal pericardial thickness exclude the diagnosis of constrictive pericarditis or reduce the effectiveness of pericardiectomy?

Population

143 patients with surgically proven constrictive pericarditis who underwent pericardiectomy at Mayo Clinic…

Comparison

Normal pericardial thickness (≤2 mm) vs Thickened pericardium (>2 mm)

Design

Cohort

Authors

DTDeepak TalrejaEastern Virginia Medical School WEWilliam D. EdwardsGeneral Cardiology GDGordon K. DanielsonCardiac Surgery

Discussion

Member takes

Implication

Normal pericardial thickness should not exclude constrictive pericarditis; leaves open whether imaging thresholds require revision in suspected cases.

Key Points

To evaluate the clinical, pathological, and surgical features of constrictive pericarditis in patients presenting with normal histopathological pericardial thickness.
Retrospective review of baseline characteristics, surgical records, and pathology specimens from 143 consecutive patients undergoing pericardiectomy for constriction at Mayo Clinic between 1993 and 1999.
Patients were categorized by histological pericardial thickness into normal (≤2 mm, n=26) and thickened (>2 mm, n=117) cohorts.
Normal pericardial thickness was observed in 18% of patients (n=26/143), most frequently associated with prior cardiac surgery, mediastinal radiation, prior myocardial infarction, or idiopathic etiologies.
Microscopic abnormalities were present in all normal-thickness cases, characterized by focal fibrosis, inflammation, calcification, fibrin deposition, and noncaseating granulomas.
Pericardiectomy demonstrated comparable symptom relief between patients with normal thickness and those with thickened pericardium.

Structured PICO

Does normal pericardial thickness exclude the diagnosis of constrictive pericarditis or reduce the effectiveness of pericardiectomy?

Population

143 patients with surgically proven constrictive pericarditis who underwent pericardiectomy at Mayo Clinic between 1993 and 1999.

Intervention

Normal pericardial thickness (≤2 mm)

Comparator

Thickened pericardium (>2 mm)

Outcome

Clinicopathological correlates and symptom relief after pericardiectomypatient reported

Normal pericardial thickness on noninvasive imaging does not exclude constrictive pericarditis, and these patients benefit equally from pericardiectomy.

Cite This Study

Talreja et al. (2003) studied this question.

synapsesocial.com/papers/69d7267d8a0e2c5879bef9f4 https://doi.org/10.1161/01.cir.0000087606.18453.fd

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Implication

Normal pericardial thickness should not exclude constrictive pericarditis; leaves open whether imaging thresholds require revision in suspected cases.

Constrictive Pericarditis in 26 Patients With Histologically Normal Pericardial Thickness

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Constrictive Pericarditis in 26 Patients With Histologically Normal Pericardial Thickness

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider