Clinical and Echocardiography Outcomes Following Pericardiectomy in Chronic Constrictive Pericarditis

Export Introduction: The leading cause of chronic constrictive pericarditis differs according to geographic location. Tuberculosis remains the most common cause of constrictive pericarditis in Africa and Asia, whereas in western countries, it remains a rare entity and idiopathic causes remain the most common etiology. Here, our aim was to study the clinical and echocardiography outcomes postpericardiectomy and compare it with other previous clinical studies. Materials and Methods: This is a retrospective study of 12 months with a mean follow-up period of 2.40 ± 2.01 years. PHILIPS EPIQ 7C machine was used for echocardiographic analysis. Mitral and tricuspid inflow velocities were detected using pulsed-wave Doppler in apical four-chamber view with a sample volume of 2–4 mm. Results: All the patients in the study population presented with dyspnea 19 (100%). Annulus reversus was observed in all our patients (19, 100%), which resolved completely postoperatively. The mean duration of hospital stay was 26.63 ± 13.09 days with a mean intensive care unit stay of 5.89 ± 2.4 days. Discussion: CVP decreased from a mean of 31.9±4.89mmHg preoperatively to 12.95 ± 3.84 mmHg in the immediate postoperative period. Significant reduction (P < 0.001) was noted in inspiratory mitral E velocity without significant change in expiratory mitral E velocity. Significant respirophasic variation was noted in all patients’ mitral and tricuspid E velocity (P < 0.001). Discussion: Different from international studies, we observed pericarditis in younger age group with a mean age of 26.58 ± 11.9 years which could be accountable to tuberculosis in young generation in India, as also observed by other Indian studies. In our study, there was significant respirophasic variation in the mitral and tricuspid E velocity in all patients (P < 0.001). Conclusions: Studies on detailed echocardiographic evaluation in terms of various parameters like mitral and tricuspid E velocities and tissue Doppler imaging are sparse. This study adds to the important role of echocardiography in assessment of chronic constrictive pericarditis.