Results of Radical Pericardiectomy for Constrictive Pericarditis

The use of pericardiectomy for constrictive pericarditis, first proposed by Delorme in 18951and first successfully applied by Rehn in 1913,2has evolved through the usual stages of (1) slow acceptance, (2) timid application and disappointing failures, and (3) gradually increasing boldness in advising and performing the operation, culminating in the application of improved techniques that now yield increasingly satisfactory results. Evidence of a greater willingness to advise the operation is shown in the acceptance of the principle that, whenever symptoms of compression of the heart appear in the presence of presumed active tuberculous pericarditis, decompressive procedures such as aspiration of fluid and decortication are indicated. Evidence of a more aggressive approach to the surgical problem involved is the recognition of the need of performing a more extensive and radical pericardiectomy if the desired results are to be attained. In the past, certain authors have accepted a long delay