Original articleAdult cardiacPericardiectomy for Constrictive Pericarditis: 20 Years of Experience at the Montreal Heart Institute
Section snippets
Study Population and Study Design
From January 1994 through February 2014, 99 consecutive patients underwent total or partial pericardiectomy at the Montreal Heart Institute, and they constitute the subjects of this report. Only the patients in whom the main surgical indication was CP were considered in the study. We also excluded the cases in which the pericardiectomy was an unplanned procedure, performed after an intraoperative finding of CP. The patients' clinical charts were reviewed, and preoperative, intraoperative, and
Preoperative Characteristics
Table 1 shows the preoperative characteristics of patients. In two thirds of cases, CP was idiopathic. The miscellaneous causes of CP were prior chest trauma in 2 patients, malignancy in 1 patient, and myocardial infarction in 6 patients. The duration of symptoms was less than 6 months only in 47% of patients, and the remaining patients had symptoms for longer than 6 months, in some cases years. Two thirds of patients were in NYHA functional class III or IV.
Intraoperative Findings
The patients’ intraoperative
Comment
The clinical outcome of pericardiectomy for CP remains constrained by high operative mortality. Our study has highlighted that some pre-and intra-operative factors, mainly related to the clinical condition of the patients, can adversely affect the short term outcome. However, if patients make it through the operation, the long-term survival and the clinical improvement are excellent in most cases.
Hospital mortality was 9% in our series (7.9% in cases of isolated pericardiectomy and 11.1% in
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