title: Surgical treatment of pericarditis in the dialysis patient.
abstract: Eighteen patients with pericarditis complicating chronic renal failure who were unresponsive to medical therapy underwent surgical decompression of the pericardium for either pericardial tamponade [16] or constrictive pericarditis [2]. There was one perioperative death and minimal morbidity. Preoperative pericardiocentesis in nine patients afforded only temporary relief in most of the patients and caused a life-threatening pericardial tamponade in one patient. Creation of a pericardial window through a left anterior thoracotomy was the procedure of choice in patients without signs of constrictive pericarditis or posterior loculated effusions and had excellent long-term results. We recommend early surgical treatment of uremic pericarditis in all patients with hemodynamic instability, enlarging pericardial effusion, or effusion that is unresponsive to intensive medical therapy.
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D006435:Renal Dialysis