A Comprehensive Study on Constrictive Pericarditis in our Institution

Abstract

Objective: We sought to determine the common etiology,

age distribution, gender prediliction, symptomatology, surgery

and its outcome of constrictive pericarditis in our institute.

Background: Constrictive pericarditis is the result of a

spectrum of primary cardiac and non-cardiac conditions.

Pericardiectomy is associated with a high prevalence of

morbidity and mortality. We evaluated the predictors

of complications and outcome of pericardiectomy procedure

for patients with constrictive pericarditis (CP) in a

single-center. Methods: A total of 11 patients who underwent

pericardiectomy for constrictive pericarditis over a 3 year

period at a single surgical centre were studied retrospectively.

Results: Etiology of constrictive pericarditis was idiopathic in

5 patients (45.4%),Tuberculosis in 3 patients (27.3%),

bacterial pericarditis in 2 patients (18.2%), and viral

pericarditis in 1 (9.09%). Age distribution was between 17

years and 64 years with mean age of 39.8 years. Males

(81.2%) are more affected than females. Presented with

dyspnea on exertion, chest pain, palpitations, right

ventricular failure, and shock. The Surgical approach was

through left anterolateral thoracotomy in 4 patients and

through median sternotomy in 7 patients. Cardiopulmonary

bypass was used in 1 patients. Median follow up among

survivors was 1.2 years (range 2 months to 2 years).

Perioperative mortality was 18.2%. The main cause of death

was severe low cardiac output syndrome and bleeding.

Postoperative complications were low cardiac output

syndrome, bleeding, pneumonia, and wound infection.

One-year survival was 72.7%. Conclusion : Pericardiectomy

is associated with lower perioperative and late mortality, and

the extent of pericardial resection should be decided

according to individual conditions. Perioperative management

and complete release of the thickened pericardium should

prevent postoperative complications. Patients should be

referred before the onset of Class 4 symptoms to minimize

postoperative mortality and low cardiac output.