[Pericardiectomy: a challenge, a reality. The surgical experience of the Instituto Nacional de Cardiología "Ignacio Chávez"].
The surgical aspect of the pericardial disease has grown in the last years due to new diagnostic, surgical and anesthetic procedures. We reviewed 20 patients, who underwent pericardiectomy in the National Institute of Cardiology "Ignacio Chávez" between august 1987 and september 1992. Nine males and eleven females whose age ranged from 18 years to 57 years with a mean of 35.8 years. We found as causes of pericardial disease: 5 patients with recurrent pericardial effusion, 4 constrictive pericarditis, 2 cases with uremic pericarditis, 2 cases of "postpericardiotomy syndrome" 2 cases of infectious origin, idiopathic causes in two, others less frequent causes were neoplastic pericarditis in one, post-traumatic in one and secondary to radiotherapy in another one. The diagnosis was made by clinical findings, chest X rays, echocardiography and cardiac catheterization. A medial sternotomy was made in all patients, and the pericardium resection was made toward the anterior aspect of the phrenic nerve. In all the patients operative monitoring included central venous catheter and radial indwelling catheter, Swan Ganz catheter in 12 cases (60%) and cardiopulmonary bypass available. One death was reported in an uremic patient, secondary to low cardiac output and multiple organic failure. One year mortality increased to 10% with the inclusion of a rhabdomyosarcoma. Surgical complications included two cases (10%) with supraventricular arrhythmias, one case (5%) incomplete right bundle branch block, postoperative bleeding one (5%) and other one (5%) postoperative mediastinitis.(ABSTRACT TRUNCATED AT 250 WORDS)
Lozano Torres
V M
VM
Servicio de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Urrea Ramos
M S
MS
Herrera Alarcón
V
V
Celaya Lara
S
S
Choles Pérez
F
F
D000293:Adolescent; D000328:Adult; D002300:Cardiac Care Facilities / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010490:Pericardial Effusion / Q000401:mortality / Q000601:surgery; D010492:Pericardiectomy / Q000401:mortality / Q000706:statistics & numerical data; D010494:Pericarditis, Constrictive / Q000401:mortality / Q000601:surgery; D012008:Recurrence
Pericardiectomía "un reto, una realidad". Experiencia quirúrgica del Instituto Nacional de Cardiología "Ignacio Chávez".