Pericardiectomy for constrictive pericarditis resulted in an 11% hospital mortality in the last 12 years, with 63 of 72 followed patients achieving NYHA class I or II functional capacity.
Cohort (n=118)
No
What are the early and late outcomes of pericardiectomy in patients with constrictive pericarditis?
Pericardiectomy improves functional capacity in most survivors with constrictive pericarditis, though advanced preoperative disability is associated with higher mortality, supporting early surgical intervention.
The medical records of 118 patients (86 male, 32 female, age 10-50 (mean 27) years) who underwent pericardiectomy for constrictive pericarditis at the Christian Medical College Hospital, Vellore, from 1954 to 1985 were reviewed. All had appreciable pericardial constriction. Preoperatively 97 of the 118 were in class III or IV of the New York Heart Association classification and 100 had peripheral oedema or ascites. Tuberculosis was proved as the cause in 72 patients. Pericardiectomy was accomplished through a standard anterolateral thoracotomy (107 cases), median sternotomy (3 cases), or bilateral thoracotomy (8 cases). Postoperatively an apparent low cardiac output state was seen in 34 patients, 12 of whom died. Hospital mortality in the last 12 years was 11%. Mortality was higher in NYHA class III and IV patients. The improved surgical results recently may be related to increased use of inotropic support and prolonged ventilation. At follow up there were 72 patients in whom functional capacity could be assessed; 63 were in class I or II. The poor results of pericardiectomy in some patients are likely to be related to advanced preoperative disability and early pericardiectomy is therefore recommended.
Bashi et al. (Mon,) conducted a cohort in Constrictive pericarditis (n=118). Pericardiectomy was evaluated on Hospital mortality and functional capacity at follow-up. Pericardiectomy for constrictive pericarditis resulted in an 11% hospital mortality in the last 12 years, with 63 of 72 followed patients achieving NYHA class I or II functional capacity.