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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2006 April;19(2):141-3
Pericardiectomy for chronic constrictive pericarditis
Al-Shammari F. 1, Ayed A. 1, 2, Jamal-Eddine H. 1, Al-Ruwaih A. 1
1 Department of Cardiothoracic Surgery Chest Diseases Hospital Faculty of Medicine, Kuwait University, Kuwait
2 Department of Surgery Faculty of Medicine, Kuwait University, Kuwait
Aim. Aim of the study is to descrive the surgical technique, and results of pericardiectomy for chronic constrictive pericarditis.
Method. A retrospective study in the Tertiary care hospital of Kuwait has been taken on 17 patients with chronic constrictive pericarditis. Pericardiectomy using sternotomy or anterolateral thoractomy approach has been undertaken. The cause of pericarditis, postoperative complications, mortality, improvement in symptoms, and follow up.
Results. The causes of pericarditis were tuberculosis in 10 patients, idiopathic in 3 patients, traumatic in 2, neoplastic, and pyogenic one in each. We performed 17 cases of pericardiectomy over a 10- year period using either the thoracotomy (9cases) or the sternotomy (8cases) approach. There was no operative mortality. One patient required cardiopulmonary bypass due to severe adhesions and bleeding. Six patients (35%) developed early postoperative complications; low cardiac output is the most common. In the first postoperative month, functional capacity improved: the number of patients in New York Heart Association functional class IV moved from 6(preoperatively) to 0; in class III, from 11 to 3; in class II from 0 to 6; and in class I, from 0 to 8.
Conclusion. TB remains one of the most common causes of chronic constrictive pericarditis in the developing world. Surgical pericardiectomy remains the only option to improve survival and relief of symptoms of patients with this condition. The mortality and morbidity of this condition have declined in the last 20 years.