Results and Outcomes for Patients with Constrictive Pericarditis following Pericardiectomy

All articles of this category Background: Constrictive pericarditis (CP) represents a relatively uncommon form of heart failure, secondary to a noncompliant pericardium. The prevalence is observed in 0.4% of patients who have undergone cardiac surgery or have had pericardial inflammation due to a different etiology. However, there is a scarcity of publications, demonstrating the outcomes after surgery for CP. Therefore, this study sought to investigate the outcome of pericardiectomy for constrictive pericarditis. Method: This is a retrospective single-center cohort study. Between 2010 and 2020, a total of 47 patients with constrictive pericarditis were treated in our institution operatively. Cardiac catheterization was performed to confirm a diagnosis of diastolic dysfunction secondary to pericardial constriction. Results: This study included 30 males and 17 females with a mean age of 58 ± 14 years. The primary etiology was idiopathic in more than 50% of the patients, followed by prior cardiac surgery. 65% of patients had a preoperative functional status of New York Heart Association (NYHA) class III or IV. All patients received either radical 38% or partial 62% pericardiectomy. In 77% of patients beating heart surgery was performed. Postoperative outcomes with respect to (stroke = 0.0%; major bleeding = 8.5%, in-hospital mortality = 6%) are demonstrated in [ Table 1 ]. Table 1 Postoperative outcomes of patients undergoing pericardiectomy Mean (min; max) or no., (%) Dialysis 4 (8.5%) Stroke 0 (0%) Bleeding 4 (8.5%) ECMO implantation 1 (2%) In-hospital mortality 3 (6%) Conclusion: Constrictive pericarditis is severe and unusual form of diastolic heart failure and its only curative treatment is surgical pericardiectomy. To prevent bleeding, cardiopulmonary bypass should be used only if additional cardiac surgery must be performed at the same time. However, a cardiopulmonary bypass should be kept ready in case bleeding occurs during the procedure. Due to the rare occurrence, registry data might help address more scientific value concerning therapeutic measures and outcomes of this disease. Publication History Article published online: 03 February 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany