Anterior Pericardiectomy for Postinfective Constrictive Pericarditis: Intermediate-Term Outcomes

The Annals of Thoracic Surgery
Anil AcharyaBijoy Rajbanshi

Abstract

Posttubercular constrictive pericarditis is prevalent pericardial disease in developing countries. Pericardiectomy is the treatment of choice but considered a procedure of high morbidity and mortality. From January 2003 to December 2013 we performed 130 pericardiectomies. The patients' mean age was 22.95 ± 12.55 years, and there were 92 (71%) male patients. All patients were symptomatic; 118 (91%) were in New York Heart Association functional class III or IV. Almost all patients were diagnosed to be of tubercular origin: 14 (11%) were histopathologically proven, 77 (59%) had definitive history, 39 (30%) were suspected to be of tubercular origin, and 91 (70%) received prior antitubercular treatment. Anterior pericardiectomy was done without the use but with provision for cardiopulmonary bypass, which was required in 5 (3.8%) patients for repair of tear in right atrium. Following pericardiectomy central venous pressure dropped from 20.9 to 10.8 mm Hg. Early mortality was 10 (7.69%). Prolonged ventilation was required in 22 (16.92%) patients, 31 (23.84%) developed renal dysfunction, and there were 3 (3.12%) cases of new-onset atrial fibrillation. On analysis of univariate predictors for early mortality, low ejection fraction (p < ...Continue Reading

Citations

Sep 4, 2019·Transplantation·Jenna L ArmstrongMani A Daneshmand
Mar 17, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Victor C LiuHarish Ramakrishna
Jun 24, 2021·Journal of Cardiothoracic Surgery·Zainab FaizaLawrence S Lee

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