Titre du document / Document title

Pericardiectomy for constrictive pericarditis : A clinical, echocardiographic, and hemodynamic evaluation of two surgical techniques

Auteur(s) / Author(s)

CHOWDHURY Ujjwal K. ⁽¹⁾ ; SUBRAMANIAM Ganapathy K. ⁽¹⁾ ; SAMPATH KUMAR A. ⁽¹⁾ ; AIRAN Balram ⁽¹⁾ ; SINGH Rajvir ⁽¹⁾ ; TALWAR Sachin ⁽¹⁾ ; SETH Sandeep ⁽¹⁾ ; MISHRA Pankaj K. ⁽¹⁾ ; PRADEEP Kizakke K. ⁽¹⁾ ; SATHIA Siddhartha ⁽¹⁾ ; VENUGOPAL Panangipalli ⁽¹⁾ ; RUBIN Joseph W. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, INDE

Résumé / Abstract

Background. This study was designed to compare the outcomes after total versus partial pericardiectomy clinically, echocardiographically, and hemodynamically. Methods. Three hundred ninety-five patients undergoing pericardiectomy for constrictive pericarditis between January 1985 and December 2004 were studied. Age was 10 months to 71 years (mean, 25.1 ± 13.4 years). Three hundred thirty-eight patients (85.6%) underwent total pericardiectomy (group I), and 57 patients (14.4%) underwent partial pericardiectomy (group II). Results. Operative and late mortality rates were 7.6% and 4.9%, respectively. Preoperative high right atrial pressure, hyperbilirubinemia, renal dysfunction, atrial fibrillation, pericardial calcification, thoracotomy approach, and partial pericardiectomy were significant risk factors for death. The risk of death was 4.5 times higher (95% confidence interval: 2.05 to 9.75) in patients undergoing partial pericardiectomy. At a mean follow-up of 17.9 ± 0.3 years (95% confidence interval: 17.3 to 18.6), actuarial survival was 83.8% ± 0.04% in group I and 73.9% ± 0.06% in group II (p = 0.004). At their last follow-up, 96.3% survivors of group I and 79.1% survivors of group II were in New York Heart Association class I/II (p < 0.001). Conclusions. Total pericardiectomy is associated with lower perioperative and late mortality, and confers significant long-term advangage by providing superior hemodynamics that appear to be independent of the etiology of constrictive pericarditis.

Revue / Journal Title

The Annals of thoracic surgery   ISSN 0003-4975   CODEN ATHSAK 

Source / Source

2006, vol. 81, n^o2, pp. 522-530 [9 page(s) (article)] (15 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier Science, New York, NY, ETATS-UNIS  (1965) (Revue)

Mots-clés anglais / English Keywords

Sonography ; Pericardial disease ; Heart disease ; Cardiovascular disease ; Treatment ; Thorax ; Technique ; Evaluation ; Hemodynamics ; Echocardiography ; Pericardiectomy ; Surgery ; Respiratory disease ; Pericarditis ;

Mots-clés français / French Keywords

Exploration ultrason ; Péricarde pathologie ; Cardiopathie ; Appareil circulatoire pathologie ; Traitement ; Thorax ; Technique ; Evaluation ; Hémodynamique ; Echocardiographie ; Péricardectomie ; Chirurgie ; Appareil respiratoire pathologie ; Péricardite ;

Mots-clés espagnols / Spanish Keywords

Exploración ultrasonido ; Pericardio patología ; Cardiopatía ; Aparato circulatorio patología ; Tratamiento ; Tórax ; Técnica ; Evaluación ; Hemodinámica ; Ecocardiografía ; Pericardiectomía ; Cirugía ; Aparato respiratorio patología ; Pericarditis ;

Localisation / Location

INIST-CNRS, Cote INIST : 13779, 35400013466496.0190