title: Surgical management of effusive constrictive pericarditis.
abstract: OBJECTIVE
  The surgical approach for effusive constrictive pericarditis (ECP) has not been extensively studied. We present our institution's early and long-term results of pericardiectomy in our cohort of patients with ECP.
  
  
  METHODS
  Diagnosis was made primarily by echocardiography. Right heart catheterisation was performed in eight patients. Pre-operatively, 10 patients had undergone at least one previous attempt at therapeutic pericardiocentesis. Pericardiectomy was performed where appropriate (thickened or inflamed).
  
  
  RESULTS
  Of our 12 patients (50% male, median age 48 years, range 17-72 years), the underlying aetiology included idiopathic in five (41.6%), tuberculosis in four (33%), and malignancy in three patients (25%). Elective surgery was performed in nine patients. Median values of both central venous pressure and pulmonary capillary wedge pressure decreased markedly postoperatively (from 16.5 to 11.0 mmHg, p = 0.02; 20.0-15.0 mmHg, p = 0.01, respectively). There was no in-hospital mortality. Follow up ranged from three months to nine years (median three years). Five (41.6%) patients died during the follow-up period, and cumulative two-year survival was 55.6 ± 1.5%.
  
  
  CONCLUSIONS
  Pericardiectomy for ECP was effective, in terms of our early results, in patients unresponsive to medical therapy. Long-term survival depends on the underlying disease.
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Fuat
authors.initials: F
authors.lastname: Buyukbayrak
authors.forename: Eray
authors.initials: E
authors.lastname: Aksoy
authors.forename: Serpil
authors.initials: S
authors.lastname: Tas
authors.forename: Kaan
authors.initials: K
authors.lastname: Kirali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002496:Central Venous Pressure; D004452:Echocardiography; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D010492:Pericardiectomy / Q000009:adverse effects / Q000401:mortality; D020519:Pericardiocentesis; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011669:Pulmonary Wedge Pressure; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
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