Pericardiectomy for constrictive pericarditis at a single Japanese center: 20 years of experience.
Gen Thorac Cardiovasc Surg
; 70(5): 430-438, 2022 May.
Article
in En
| MEDLINE
| ID: mdl-35119592
ABSTRACT
OBJECTIVE:
Constrictive pericarditis (CP) is a rare disease, and the diagnosis and surgical treatment of CP remain challenging. The aim of this study was to evaluate our Japanese single-center experience with isolated pericardiectomy for CP to elucidate the factors associated with improved outcomes.METHODS:
Over a 20-year period, 44 consecutive patients underwent isolated pericardiectomy at our institution. The cause of CP was idiopathic (59%), postsurgical (32%), tuberculosis (7%), and postradiation (2%) of the patients. All patients were diagnosed with CP using multiple modalities, including echocardiography, cardiac catheterization, computed tomography, or magnetic resonance imaging (MRI). Median sternotomy was performed in 42 (95%) patients. Twenty-eight (68%) patients underwent radical pericardiectomy.RESULTS:
The postoperative diagnosis in all patients was CP. Among the multiple modalities, cardiac MRI had the greatest diagnostic sensitivity (97.2%). There were no operative or hospital deaths; late mortality occurred in seven (15.9%) patients in the series. Multivariable analysis showed that preoperative low LVEF was a risk factor for long-term mortality. Seven patients were readmitted for heart failure postoperatively. Multivariable analysis showed incomplete pericardiectomy and use of a preoperative inotrope were risk factors for readmission for heart failure.CONCLUSIONS:
The diagnosis using multimodality imaging for CP was effective in our institution and tagged cine MRI had the greatest sensitivity in diagnosing CP. Preoperative condition, including preoperative low LVEF or inotrope use, was correlated with long-term outcome after pericardiectomy. Pericardiectomy should be performed early and as radically as possible to prevent recurrent heart failure.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pericarditis, Constrictive
/
Heart Failure
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Gen Thorac Cardiovasc Surg
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Japan
Publication country:
JAPAN
/
JAPON
/
JAPÃO
/
JP