Surgical experience with chronic constrictive pericarditis.
OBJECTIVE
Constrictive pericarditis is a disease characterized by marked thickening of the pericardium which causes restriction of diastolic cardiac function. The purpose of this report is to review the outcome of pericardiectomy for constrictive pericarditis and to discuss its problems.


METHODS
Sixteen consecutive patients who underwent pericardiectomy for constrictive pericarditis in our institution between March 2000 and June 2011 were reviewed. All patients underwent decortication including at least the anterior surface from the right atrium to the left phrenic nerve and the diaphragmatic surface of the heart. The epicardium was concomitantly resectioned because it was usually sclerotic and constrictive.


RESULTS
Postoperatively, mean central venous pressure decreased to 8.8 ± 3.1 mmHg and was significantly lower than the preoperative value 15.3 ± 3.7 mmHg (p < 0.001). The mean postoperative duration of hospitalization was 25.6 ± 13.5 days. There were 2 in-hospital deaths and early mortality rate was 12.5 %; however, excluding hospital deaths, there were no significant postoperative complications and all survivors recovered and maintained good cardiac function during the mean follow-up period of 3.7 ± 2.8 years.


CONCLUSIONS
For an acceptable outcome, surgical intervention should be performed at an appropriate time and the pericardiectomy should have proper scope and depth to prevent irreversible changes in the heart, liver, and other organs.
Department of Cardiovascular Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. tsuneoariyoshi@infoseek.jp
Tsuneo
T
Ariyoshi
Koji
K
Hashizume
Shinichiro
S
Taniguchi
Takashi
T
Miura
Kazuyoshi
K
Tanigawa
Seiji
S
Matsukuma
Tomohiro
T
Odate
Shun
S
Nakaji
Mizuki
M
Sumi
Kiyoyuki
K
Eishi
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010492:Pericardiectomy / Q000009:adverse effects / Q000379:methods; D010494:Pericarditis, Constrictive / Q000601:surgery*; D010496:Pericardium / Q000503:physiopathology / Q000601:surgery