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. 2012;39(2):199-205.

Constrictive pericarditis treated by surgery

Alireza A Ghavidel  1 , Maziar Gholampour, Majid Kyavar, Yalda Mirmesdagh, Mohammad-Bagher Tabatabaie
Affiliations

Constrictive pericarditis treated by surgery

Alireza A Ghavidel et al. Tex Heart Inst J. 2012.

Abstract

We reviewed the records of 45 patients (mean age, 46.6 ± 14.9 yr; range, 21-84 yr) with a diagnosis of constrictive pericarditis who had undergone pericardiectomy from 1994 through 2006. Preoperatively, 2 of the patients (4.4%) were in New York Heart Association (NYHA) functional class I, 20 (44.4%) in class II, 22 (48.9%) in class III, and 1 (2.2%) in class IV. Pericardial calcification was detected in 20% of plain chest radiographs. Constrictive pericarditis was caused by tuberculosis in 22.2%, chronic renal failure in 8.9%, a history of sternotomy in 4.4%, and malignancy in 4.4%. The cause was idiopathic in 60% of the patients. Low-output state was the most common postoperative problem (22.2%). The mean follow-up period was 40 ± 18 months (range, 3-144 mo). Three months postoperatively, only 1 of 43 available patients (2.3%) was in NYHA class III, while the rest were in class I (36 patients; 83.7%) or II (6 patients; 14%). The overall mortality rate was 4.4%: 1 patient with tuberculosis died of respiratory insufficiency while hospitalized, and 1 died of metastatic adenocarcinoma during follow-up. Our results show that pericardiectomy remains an effective procedure in the treatment of constrictive pericarditis. Tuberculosis is still an important cause of constrictive pericarditis in Iran, despite intensive vaccination and use of antitubercular drugs.

Keywords: Calcinosis; heart failure; low-output syndrome; pericardial effusion; pericardiectomy; pericarditis, constrictive/complications/surgery; pericarditis, tubercular/surgery; recovery of function; retrospective studies; treatment outcome.

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Figures

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Fig. 1 Comparison of the use of inotropic agents during the perioperative and late postoperative periods.
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Fig. 2 Postoperative improvement in functional status on the basis of New York Heart Association (NYHA) functional class at 3 months.
See this image and copyright information in PMC

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