Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1988 Aug;43(8):637–641. doi: 10.1136/thx.43.8.637

Early and late results of pericardiectomy in 118 cases of constrictive pericarditis.

V V Bashi 1, S John 1, E Ravikumar 1, P S Jairaj 1, K Shyamsunder 1, S Krishnaswami 1
PMCID: PMC461401  PMID: 3175976

Abstract

The medical records of 118 patients (86 male, 32 female, age 10-50 (mean 27) years) who underwent pericardiectomy for constrictive pericarditis at the Christian Medical College Hospital, Vellore, from 1954 to 1985 were reviewed. All had appreciable pericardial constriction. Preoperatively 97 of the 118 were in class III or IV of the New York Heart Association classification and 100 had peripheral oedema or ascites. Tuberculosis was proved as the cause in 72 patients. Pericardiectomy was accomplished through a standard anterolateral thoracotomy (107 cases), median sternotomy (3 cases), or bilateral thoracotomy (8 cases). Postoperatively an apparent low cardiac output state was seen in 34 patients, 12 of whom died. Hospital mortality in the last 12 years was 11%. Mortality was higher in NYHA class III and IV patients. The improved surgical results recently may be related to increased use of inotropic support and prolonged ventilation. At follow up there were 72 patients in whom functional capacity could be assessed; 63 were in class I or II. The poor results of pericardiectomy in some patients are likely to be related to advanced preoperative disability and early pericardiectomy is therefore recommended.

Full text

PDF
637

Images in this article

638Image
on p.638
639Image
on p.639

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Applefeld M. M., Slawson R. G., Hall-Craigs M., Green D. C., Singleton R. T., Wiernik P. H. Delayed pericardial disease after radiotherapy. Am J Cardiol. 1981 Feb;47(2):210–213. doi: 10.1016/0002-9149(81)90386-6. [DOI] [PubMed] [Google Scholar]
  2. Baue A. E., Blakemore W. S. The pericardium. Ann Thorac Surg. 1972 Jul;14(1):81–106. doi: 10.1016/s0003-4975(10)65204-6. [DOI] [PubMed] [Google Scholar]
  3. Blake S., Bonar S., O'Neill H., Hanly P., Drury I., Flanagan M., Garrett J. Aetiology of chronic constrictive pericarditis. Br Heart J. 1983 Sep;50(3):273–276. doi: 10.1136/hrt.50.3.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cooper D. K., Cleland W. P., Bentall H. H. Collagen diseases as a cause of constrictive pericarditis. Thorax. 1978 Jun;33(3):368–371. doi: 10.1136/thx.33.3.368. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Copeland J. G., Stinson E. B., Griepp R. B., Shumway N. E. Surgical treatment of chronic constrictive pericarditis using cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1975 Feb;69(2):236–238. [PubMed] [Google Scholar]
  6. Culliford A. T., Lipton M., Spencer F. C. Operation for chronic constrictive pericarditis: Do the surgical approach and degree of pericardial resection influence the outcome significantly? Ann Thorac Surg. 1980 Feb;29(2):146–152. doi: 10.1016/s0003-4975(10)61653-0. [DOI] [PubMed] [Google Scholar]
  7. DINES D. E., EDWARDS J. E., BURCHELL H. B. Myocardial atrophy in constrictive pericarditis. Proc Staff Meet Mayo Clin. 1958 Feb 19;33(4):93–99. [PubMed] [Google Scholar]
  8. Das P. B., Gupta R. P., Jairaj P. S., John S., Sukumar I. P., Cherian G. Constrictive pericarditis and its surgical management. Int Surg. 1975 Apr;60(4):210–214. [PubMed] [Google Scholar]
  9. Das P. B., Krishnaswami S., John S. Myocardial function and its effects on the surgical treatment of constrictive pericarditis. Indian Heart J. 1975 Apr;27(2):127–131. [PubMed] [Google Scholar]
  10. Desai H. N. Tuberculous pericarditis. A review of 100 cases. S Afr Med J. 1979 May 26;55(22):877–880. [PubMed] [Google Scholar]
  11. EHRENHAFT J. L., TABER R. E. Hemopericardium and constrictive pericarditis. J Thorac Surg. 1952 Oct;24(4):355–368. [PubMed] [Google Scholar]
  12. Ghose J. C., Saha P., Burdhan A., Chhetri M. K. Left ventricular function in chronic constrictive pericarditis before and after pericardiectomy. J Assoc Physicians India. 1977 Dec;25(12):851–857. [PubMed] [Google Scholar]
  13. Gooi H. C., Smith J. M. Tuberculous pericarditis in Birmingham. Thorax. 1978 Feb;33(1):94–96. doi: 10.1136/thx.33.1.94. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hancock E. W. Subacute effusive-constrictive pericarditis. Circulation. 1971 Feb;43(2):183–192. doi: 10.1161/01.cir.43.2.183. [DOI] [PubMed] [Google Scholar]
  15. Harrington S. W. Chronic Constrictive Pericarditis: Partial Pericardiectomy and Epicardiolysis in Twenty-Four Cases. Ann Surg. 1944 Oct;120(4):468–485. doi: 10.1097/00000658-194410000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Harrison E. C., Crawford D. W., Lau F. Y. Sequential left ventricular function studies before and after pericardiectomy for constrictive pericarditis. Delayed resolution of residual restriction. Am J Cardiol. 1970 Sep;26(3):319–323. doi: 10.1016/0002-9149(70)90801-5. [DOI] [PubMed] [Google Scholar]
  17. John J. T., Jr, Hough A., Sergent J. S. Pericardial disease in rheumatoid arthritis. Am J Med. 1979 Mar;66(3):385–390. doi: 10.1016/0002-9343(79)91056-8. [DOI] [PubMed] [Google Scholar]
  18. Kilman J. W., Bush C. A., Wooley C. F., Stang J. M., Teply J., Baba N. The changing spectrum of pericardiectomy for chronic pericarditis: occult constrictive pericarditis. J Thorac Cardiovasc Surg. 1977 Nov;74(5):668–673. [PubMed] [Google Scholar]
  19. Kutcher M. A., King S. B., 3rd, Alimurung B. N., Craver J. M., Logue R. B. Constrictive pericarditis as a complication of cardiac surgery: recognition of an entity. Am J Cardiol. 1982 Oct;50(4):742–748. doi: 10.1016/0002-9149(82)91228-0. [DOI] [PubMed] [Google Scholar]
  20. Lall Gupta R. Pericardectomy for constrictive pericarditis. Indian Heart J. 1971 Oct;23(4):292–295. [PubMed] [Google Scholar]
  21. Marsa R., Mehta S., Willis W., Bailey L. Constrictive pericarditis after myocardial revascularization: report of three cases. Am J Cardiol. 1979 Jul;44(1):177–183. doi: 10.1016/0002-9149(79)90268-6. [DOI] [PubMed] [Google Scholar]
  22. Martin R. G., Ruckdeschel J. C., Chang P., Byhardt R., Bouchard R. J., Wiernik P. H. Radiation-related pericarditis. Am J Cardiol. 1975 Feb;35(2):216–220. doi: 10.1016/0002-9149(75)90004-1. [DOI] [PubMed] [Google Scholar]
  23. McCaughan B. C., Schaff H. V., Piehler J. M., Danielson G. K., Orszulak T. A., Puga F. J., Pluth J. R., Connolly D. C., McGoon D. C. Early and late results of pericardiectomy for constrictive pericarditis. J Thorac Cardiovasc Surg. 1985 Mar;89(3):340–350. [PubMed] [Google Scholar]
  24. Meaney E., Shabetai R., Bhargava V., Shearer M., Weidner C., Mangiardi L. M., Smalling R., Peterson K. Cardiac amyloidosis, contrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol. 1976 Nov 4;38(5):547–556. doi: 10.1016/s0002-9149(76)80001-x. [DOI] [PubMed] [Google Scholar]
  25. Miller J. I., Mansour K. A., Hatcher C. R., Jr Pericardiectomy: current indications, concepts, and results in a university center. Ann Thorac Surg. 1982 Jul;34(1):40–45. doi: 10.1016/s0003-4975(10)60850-8. [DOI] [PubMed] [Google Scholar]
  26. Ortbals D. W., Avioli L. V. Tuberculous pericarditis. Arch Intern Med. 1979 Feb;139(2):231–234. [PubMed] [Google Scholar]
  27. PETERSEN V. P., HASTRUP J. Protein-losing enteropathy in constrictive pericarditis. Acta Med Scand. 1963 Apr;173:401–410. doi: 10.1111/j.0954-6820.1963.tb17423.x. [DOI] [PubMed] [Google Scholar]
  28. Shabetai R., Fowler N. O., Guntheroth W. G. The hemodynamics of cardiac tamponade and constrictive pericarditis. Am J Cardiol. 1970 Nov;26(5):480–489. doi: 10.1016/0002-9149(70)90706-x. [DOI] [PubMed] [Google Scholar]
  29. Sunder S. K., Shah A. Constrictive pericarditis in procainamide-induced lupus erythematosus syndrome. Am J Cardiol. 1975 Dec;36(7):960–962. doi: 10.1016/0002-9149(75)90089-2. [DOI] [PubMed] [Google Scholar]
  30. Viola A. R. The influence of pericardiectomy on the hemodynamics of chronic constrictive pericarditis. Circulation. 1973 Nov;48(5):1038–1042. doi: 10.1161/01.cir.48.5.1038. [DOI] [PubMed] [Google Scholar]
  31. WOOD P. Chronic constrictive pericarditis. Am J Cardiol. 1961 Jan;7:48–61. doi: 10.1016/0002-9149(61)90422-2. [DOI] [PubMed] [Google Scholar]
  32. Walsh T. J., Baughman K. L., Gardner T. J., Bulkley B. H. Constrictive epicarditis as a cause of delayed or absent response to pericardiectomy: a clinicopathological study. J Thorac Cardiovasc Surg. 1982 Jan;83(1):126–132. [PubMed] [Google Scholar]
  33. Watson P. T., Havelda C. J., Sorosky J., Kochenour N. K., Sohi G. S., Gray L., Jr Irradiation-induced constrictive pericarditis requiring pericardiectomy during pregnancy. J Reprod Med. 1980 Mar;24(3):127–130. [PubMed] [Google Scholar]
  34. Wychulis A. R., Connolly D. C., McGoon D. C. Pericardial cysts, tumors, and fat necrosis. J Thorac Cardiovasc Surg. 1971 Aug;62(2):294–300. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES