Key result
Partial pericardiectomy linked to ~11-fold higher mortality versus complete resection in constrictive pericarditis.
Why the study?
Pericardiectomy is the definitive treatment for constrictive pericarditis with high morbidity and mortality, but data on associated outcomes and risk factors remain limited.
Cohort (n=86)
No
Hazard Ratio: 11.41 (95% CI 3.052–42.663)
p-value: p=0.000
Pericardiectomy for constrictive pericarditis has acceptable mid-term survival, though preoperative moderate or greater mitral insufficiency and partial pericardiectomy are significant risk factors for 5-year mortality.
Supports pericardiectomy safety in constrictive pericarditis; leaves open whether complete resection and MI management improve survival in prospective studies.
PURPOSE: Pericardiectomy is the definitive treatment option for constrictive pericarditis and is associated with a high prevalence of morbidity and mortality. However, information on the associated outcomes and risk factors is limited. We aimed to report the mid-term outcomes of pericardiectomy from a single center in China. METHODS: We retrospectively reviewed data collected from patients who underwent pericardiectomy at our institute from April 2018 to January 2023. RESULTS: Eighty-six consecutive patients (average age, 46.1 ± 14.7 years; 68.6 men) underwent pericardiectomy through midline sternotomy. The most common etiology was idiopathic (n = 60, 69.8%), and 82 patients (95.3%) were in the New York Heart Association function class III/IV. In all, 32 (37.2%) patients underwent redo sternotomies, 36 (41.9%) underwent a concomitant procedure, and 39 (45.3%) required cardiopulmonary bypass. The 30-day mortality rate was 5.8%, and the 1-year and 5-year survival rates were 88.3% and 83.5%, respectively. Multivariable analysis revealed that preoperative mitral insufficiency (MI) ≥moderate (hazard ratio [HR], 6.435; 95% confidence interval [CI] [1.655-25.009]; p = 0.007) and partial pericardiectomy (HR, 11.410; 95% CI [3.052-42.663]; p = 0.000) were associated with increased 5-year mortality. CONCLUSION: Pericardiectomy remains a safe operation for constrictive pericarditis with optimal mid-term outcomes.
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Li et al. (2024) conducted a cohort in Constrictive pericarditis (n=86). Pericardiectomy was evaluated on 5-year mortality (risk associated with partial pericardiectomy) (HR 11.410, 95% CI 3.052-42.663, p=0.000). Pericardiectomy for constrictive pericarditis resulted in an 83.5% 5-year survival rate, with partial pericardiectomy significantly increasing 5-year mortality (HR 11.410; 95% CI 3.052-42.663; p=0.000).