title: Long-term outcomes of pericardiectomy for constrictive pericarditis.
abstract: BACKGROUND
  Constrictive pericarditis is a rare and disabling disease that can result in chronic fibrous thickening of the pericardium. The purpose of this study was to evaluate the long-term outcomes following treatment of constrictive pericarditis by pericardiectomy.
  
  
  METHODS
  Between September 1992 and May 2014, 47 patients who underwent pericardiectomy for constrictive pericarditis were retrospectively examined. Demographic, pre-, intra- and postoperative data and long-term outcomes were analyzed.
  
  
  RESULTS
  Thirty of the patients were male, the mean age was 45.8 ± 16.7. Aetiology of constrictive pericarditis was tuberculosis in 22 (46.8 %) patients, idiopathic in 15 (31.9 %), malignancy in 3 (6.4 %), prior cardiac surgery in 2 (4.3 %), non-tuberculosis bacterial infections in 2 (4.3 %), radiotherapy in 1 (2.1 %), uraemia in 1 (2.1 %) and post-traumatic in 1 (2.1 %). The surgical approach was achieved via a median sternotomy in all patients except only 1 patient. The mean operative time was 156.4 ± 45.7 min. Improvement in functional status in 80 % of patients' at least one New York Heart Association (NYHA) functional class was observed. In-hospital mortality rate was 2.1 % (1 of 47 patients). The cause of death was pneumonia leading to progressive respiratory failure. The late mortality rate was 23.4 % (11 of 47 patients). The mean follow-up time was 61.2 ± 66 months. The actuarial survival rates were 91 %, 85 % and 81 % at 1, 5 and 10 years, respectively. Recurrence requiring a repeat pericardiectomy was developed in no patient during follow-up.
  
  
  CONCLUSIONS
  Pericardiectomy is associated with high morbidity and mortality rates. Cases with neoplastic diseases, diminished cardiac output, cases in need of reoperation are expected to have high mortality rates and less chance of functional recovery.
authors.affiliation: Department of Cardiovascular Surgery, Uludağ University Medical Faculty, Bursa, Turkey. mbicer23@yahoo.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Biçer
authors.affiliation: Department of Cardiology, Uludağ University Medical Faculty, Görükle Kampüsü, Nilüfer, Bursa, 16000, Turkey. buloz2@yahoo.com.
authors.forename: Bülent
authors.initials: B
authors.lastname: Özdemir
authors.affiliation: Department of Cardiovascular Surgery, Uludağ University Medical Faculty, Bursa, Turkey. iriskan64@hotmail.com.
authors.forename: İris
authors.initials: İ
authors.lastname: Kan
authors.affiliation: Department of Cardiovascular Surgery, Uludağ University Medical Faculty, Bursa, Turkey. ahmetyuksel1982@mynet.com.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yüksel
authors.affiliation: Department of Cardiovascular Surgery, Uludağ University Medical Faculty, Bursa, Turkey. mustafatok@uludag.edu.tr.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Tok
authors.affiliation: Department of Cardiovascular Surgery, Uludağ University Medical Faculty, Bursa, Turkey. senkaya@uludag.edu.tr.
authors.forename: Işık
authors.initials: I
authors.lastname: Şenkaya
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010492:Pericardiectomy / Q000379:methods*; D010494:Pericarditis, Constrictive / Q000453:epidemiology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology