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Radical pericardiectomy for chronic constrictive pericarditis
Author(s) -
Nozohoor Shahab,
Johansson Maria,
Koul Bansi,
CunhaGoncalves Doris
Publication year - 2018
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.13715
Subject(s) - pericardiectomy , medicine , constrictive pericarditis , ejection fraction , cardiology , pericarditis , surgery , pericardium , heart failure
Background We studied the impact of radical pericardiectomy on early and long‐term patient survival, postoperative New York Heart Association (NYHA) functional class, and left ventricular ejection fraction in patients with chronic constrictive pericarditis compared to a sub‐total pericardiectomy. Methods From 1991 to 2016, 41 patients underwent pericardiectomy for chronic constrictive pericarditis. Sub‐total pericardiectomy was performed in 17 (41%) and radical pericardiectomy in 24 (59%) patients. Patients in the two study groups had statistically similar NYHA functional class, left ventricular ejection fraction, and cardiac catheterization data. Follow‐up was 100% complete with a median time of 4 years. Results Radical pericardiectomy resulted in increased survival rates at 10 years (94%) compared to sub‐total pericardiectomy (55%) ( P = 0.014). In the idiopathic chronic constrictive pericarditis sub‐group, long‐term survival rates were also increased after a radical pericardiectomy ( P = 0.001). Eighty‐five percent of patients after a radical pericardiectomy were in NYHA functional class I or II after 5 years and 94% up to 25 years versus 53% and 63%, respectively, for the sub‐total pericardiectomy group. Conclusions Radical pericardiectomy provided superior 10‐year survival and clinical functional improvement in patients with chronic constrictive pericarditis compared to sub‐total pericaridectomy.