Introduction
The mainstay of the treatment of constrictive pericarditis is
pericardiectomy. However, surgery is associated with high early morbidity
and mortality and low long-term survival. The aim of this study is to
describe our series of pericardiectomies performed over 30 years.
Methods
A descriptive, observational, and retrospective analysis of all
pericardiectomies performed at the Institute of Cardiology and
Cardiovascular Surgery of the Favaloro Foundation was performed.
Results
A total of 45 patients underwent pericardiectomy between June 1992 and June
2022, mean age was 52 years (standard deviation ± 13.9 years), and
73.3% were men. Idiopathic constrictive pericarditis was the most prevalent
(46.6%). The variables significantly associated with prolonged
hospitalization were preoperative advanced functional class (incidence of
38.4%, P<0.04), persistent pleural effusion (incidence of 81.8%,
P<0.01), and although there was no statistical significance with the use
of cardiopulmonary bypass, a trend in this association is evident
(P<0.07). We found that 100% of the patients with an onset of symptoms
greater than six months had a prolonged hospital stay. In-hospital mortality
was 6.6%, and 30-day mortality was 8.8%. The preserved functional class is
17 times more likely to improve their symptomatology after pericardiectomy
(odds ratio 17, 95% confidence interval 2.66-71; P<0.05).
Conclusion
Advanced functional class at the time of pericardiectomy is the variable most
strongly associated with mortality and prolonged hospitalization. Onset of
the symptoms greater than six months is also a poor prognostic factor mainly
associated with prolonged hospitalization; based on these data, we strongly
support the recommendation of early intervention.
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