title: Constrictive pericarditis treated by surgery.
abstract: We reviewed the records of 45 patients (mean age, 46.6 ± 14.9 yr; range, 21-84 yr) with a diagnosis of constrictive pericarditis who had undergone pericardiectomy from 1994 through 2006. Preoperatively, 2 of the patients (4.4%) were in New York Heart Association (NYHA) functional class I, 20 (44.4%) in class II, 22 (48.9%) in class III, and 1 (2.2%) in class IV. Pericardial calcification was detected in 20% of plain chest radiographs. Constrictive pericarditis was caused by tuberculosis in 22.2%, chronic renal failure in 8.9%, a history of sternotomy in 4.4%, and malignancy in 4.4%. The cause was idiopathic in 60% of the patients. Low-output state was the most common postoperative problem (22.2%). The mean follow-up period was 40 ± 18 months (range, 3-144 mo). Three months postoperatively, only 1 of 43 available patients (2.3%) was in NYHA class III, while the rest were in class I (36 patients; 83.7%) or II (6 patients; 14%). The overall mortality rate was 4.4%: 1 patient with tuberculosis died of respiratory insufficiency while hospitalized, and 1 died of metastatic adenocarcinoma during follow-up. Our results show that pericardiectomy remains an effective procedure in the treatment of constrictive pericarditis. Tuberculosis is still an important cause of constrictive pericarditis in Iran, despite intensive vaccination and use of antitubercular drugs.
authors: Department of Cardiovascular Surgery, Rajaee Cardiovascular Medical Research Center, Tehran University of Medical Science, 1996911151 Tehran, Iran. aaghavidel@yahoo.com
authors: Alireza A
authors: AA
authors: Ghavidel
authors: Maziar
authors: M
authors: Gholampour
authors: Majid
authors: M
authors: Kyavar
authors: Yalda
authors: Y
authors: Mirmesdagh
authors: Mohammad-Bagher
authors: MB
authors: Tabatabaie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007492:Iran; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010492:Pericardiectomy / Q000009:adverse effects / Q000401:mortality; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D010495:Pericarditis, Tuberculous / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult