title: Surgical management of constrictive pericarditis.
abstract: BACKGROUND
  Constrictive pericarditis is a disease characterized by marked thickening and dense scarring of the pericardium with pericardial sac obliteration, or calcification of the pericardium. Without treatment this disease is characterized by high morbidity and mortality.
  
  
  OBJECTIVE
  To review the surgical management of constructive pericarditis and the post operative challenges.
  
  
  METHODS
  Eleven patients who had pericardiectomy for constructive pericarditis between 2000 and 2005 were studied. Data was obtained from the operating theatre register, histopathological reports and patient's case notes.
  
  
  RESULTS
  The mean age was 33 years with a range of 14 to 53 years. There were seven males (63.6%) and four females (36.4%). Seven (63.6%) out of the eleven patients operated were treated for pulmonary tuberculosis. The cause of pericardial constriction in four patients (36.4%) was undetermined. Follow up period was between 4-59 months. The mean follow up was 17.5 months. Seven patients (63.6%) were off diuretics and had no exercise intolerance. Patients were classified using the New York Heart Association (NYHA) n (NYHA) functional and therapeutic classification in class I-V. Two patients preoperatively in class III are now in class I after surgery on low dose diuretics. One patient who had calcific constrictive pericarditis and came in class III was now in class II with diuretics after 3 years of follow up. There was no postoperative mortality. One patient was lost to follow up.
  
  
  CONCLUSIONS
  Pericardiectomy is a useful procedure for constrictive pericarditis and was beneficial to all the patients in this study with an improvement in their functional capacity. Intensive peri-operative monitoring and management reduced morbidity and mortality.
authors.affiliation: National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box 77, Korle Bu, Ghana.
authors.forename: M
authors.initials: M
authors.lastname: Tettey
authors.forename: L
authors.initials: L
authors.lastname: Sereboe
authors.forename: E
authors.initials: E
authors.lastname: Aniteye
authors.forename: F
authors.initials: F
authors.lastname: Edwin
authors.forename: D
authors.initials: D
authors.lastname: Kotei
authors.forename: M
authors.initials: M
authors.lastname: Tamatey
authors.forename: K
authors.initials: K
authors.lastname: Entsua-Mensah
authors.forename: K
authors.initials: K
authors.lastname: Frimpong-Boateng