Rupprecht, Leopold and Putz, Christina and Floerchinger, Bernhard and Zausig, York and Camboni, Daniele and Unsoeld, Bernhard and Schmid, Christof (2018) Pericardiectomy for Constrictive Pericarditis: An Institution's 21 Years Experience. THORACIC AND CARDIOVASCULAR SURGEON, 66 (8). pp. 645-650. ISSN 0171-6425, 1439-1902
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Background The aim of this retrospective study was to evaluate our experience with the surgical pericardiectomy procedure for patients suffering from isolated severe constrictive pericarditis. Methods From 1995 to 2016, 39 patients underwent isolated pericardiectomy for constrictive pericarditis. Fifteen patients were excluded because of concomitant surgery. There were 31 male ( 79.5%) patients and 8 female ( 20.5%) patients, 28 to 76 years old ( mean, 56.6 13.6 years). The underlying etiologies were idiopathic pericarditis ( 74.5%), infection ( 10%), rheumatic disorders ( 8%), status post cardiac surgery ( 2.5%), tuberculosis ( 2.5%), and status post mediastinal irradiation ( 2.5%). Results Pericardiectomy was performed through midline sternotomy in all cases. Sixteen patients ( 41%) underwent pericardiectomy electively employing cardiopulmonary bypass with the heart beating, and 23 patients ( 59%) had surgery without extracorporeal circulation ( ECC). The overall 30- day mortality rate was 50% if cardiopulmonary bypass was used ( 13.8% since 2007). If surgery was performed without a heart- lung machine, mortality was 0%. On- pump patients had a significantly longer intensive care unit ( ICU) stay ( 12 9 vs. 4 4 days, p 1/4 0.013). Likewise, the duration of mechanical ventilation was much longer ( 171 246 vs. 21 40 hours, p 1/4 0.04). The hospital stay was comparable with 28 10 and 24 18 days ( p 1/4 0.21). Conclusion The present study demonstrates that pericardiectomy, without the use of cardiopulmonary bypass as treatment for constrictive pericarditis, is a safe procedure with an excellent outcome in critically ill patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; pericardium; cardiopulmonary bypass; CPB; heart failure |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 10 Oct 2019 09:42 |
| Last Modified: | 10 Oct 2019 09:42 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13607 |
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