Anterior Pericardiectomy for Postinfective Constrictive Pericarditis: Intermediate-Term Outcomes

Acharya, Anil; Koirala, Raamesh; Rajbhandari, Nivesh; Sharma, Jyotindra; Rajbanshi, Bijoy G.

doi:10.1016/j.athoracsur.2018.04.048

Cited by 14 publications

(12 citation statements)

References 8 publications

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“…Lastly, this study is unable to capture outcomes for pericardiectomy performed for TB-induced pericarditis, which is the most common cause outside the United States. Studies conducted in India and Nepal, for instance, reported the vast majority of patients undergoing pericardiectomy had a history of TB or had received medical antibiotics treatment for TB prior to surgery [ 17 , 24 , 25 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Fifteen-year experience with pericardiectomy at a tertiary referral center

Faiza

Prakash

Namburi

et al. 2021

J Cardiothorac Surg

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Purpose Pericardiectomy has traditionally carried relatively high perioperative mortality and morbidity, with few published reports of intermediate- and long- term outcomes. We investigated our 15-year experience performing pericardiectomy at our institution. Methods Retrospective study of all patients who underwent pericardiectomy at our institution between 2005 and 2019. Baseline demographics, intraoperative details, and postoperative outcomes including long-term survival were analyzed. Results Sixty-three patients were included in the study. 66.7% of subjects underwent isolated pericardiectomy while 33.3% underwent pericardiectomy concomitantly with another cardiac surgical procedure. The most common indications for pericardiectomy were constrictive (79.4%) and hemorrhagic (9.5%) pericarditis. Preoperatively, 76.2% of patients were New York Heart Association class II and III, while postoperatively, 71.4% were class I and II. One-, three-, five-, and ten- year overall mortality was 9.5, 14.3, 20.6, and 25.4%, respectively. Overall pericarditis recurrence rate was 4.8%. Conclusion Pericardiectomy carries relatively high overall mortality rates, which likely reflects underlying disease etiology and comorbidities. Patients with prior cardiac intervention, history of dialysis, and immunocompromised state are associated with worse outcomes.

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Section: Discussionmentioning

confidence: 99%

Fifteen-year experience with pericardiectomy at a tertiary referral center

Faiza

Prakash

Namburi

et al. 2021

J Cardiothorac Surg

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“…Additionally, postoperative complication was the independent risk factor for prolonged ICU stay. It should be emphasized that all patients undergoing complete pericardiectomy in our department were not routinely performed cardiopulmonary bypass, which was also proven to be safe in other studies [24,25]. There are several limitations in this study.…”

Section: Discussionmentioning

confidence: 90%

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

Fang

Huang

et al. 2020

J Cardiothorac Surg

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Background: The risk factors of postoperative outcomes after pericardiectomy in tuberculous constrictive pericarditis have still been unclear. This study aimed to investigate the predictors of postoperative complication and prolonged intensive care unit (ICU) stay in the patients with tuberculous constrictive pericarditis undergoing pericardiectomy. Methods: A total of 88 patients with tuberculous constrictive pericarditis undergoing pericardiectomy were retrospectively enrolled. Logistic regression and Cox regression analysis were performed to identify the predictors of postoperative complication and prolonged ICU stay, respectively. Results: All patients underwent complete pericardiectomy and 35 (39.8%) had postoperative complication with no mortality within 30 days after surgery and no in-hospital deaths. Postoperative complication prolonged postoperative ICU stay (P < 0.001), duration of chest drainage (P < 0.001) and postoperative hospital stay (P < 0.001). Preoperative NYHA functional class (P = 0.004, OR 4.051, 95%CI 1.558-10.533) and preoperative central venous pressure (CVP) (P = 0.031, OR 1.151, 95%CI 1.013-1.309) were independent risk factors of postoperative complication. Postoperative complication (P < 0.001, HR 4.132, 95%CI 2.217-7.692) was the independent risk factor for prolonged ICU stay. Conclusion: Complete pericardiectomy was associated with high risk of postoperative complication in tuberculous constrictive pericarditis. Poor preoperative NYHA functional class and high preoperative CVP were shown to predict postoperative complication which was the predictor of prolonged ICU stay.

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Section: Discussionmentioning

confidence: 98%

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

Fang

Huang

et al. 2020

Preprint

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Purpose The risk factors of postoperative outcomes after pericardiectomy in tuberculous constrictive pericarditis have still been unclear. This study aimed to investigate the predictors of postoperative complication and prolonged intensive care unit (ICU) stay in the patients with tuberculous constrictive pericarditis undergoing pericardiectomy. Methods A total of 88 patients with tuberculous constrictive pericarditis undergoing pericardiectomy were retrospectively enrolled. Logistic regression and Cox regression analysis were performed to identify the predictors of postoperative complication and prolonged ICU stay, respectively. Results All patients underwent complete pericardiectomy and 35 (39.8%) had postoperative complications with no mortality within 30 days after surgery. Postoperative complication delayed postoperative ICU stay (P < 0.001), duration of chest drainage (P < 0.001) and postoperative hospital stay (P < 0.001). Preoperative NYHA functional class (P = 0.004, OR 4.051, 95%CI 1.558–10.533) and preoperative central venous pressure (CVP) (P = 0.031, OR 1.151, 95%CI 1.013–1.309) were independent risk factors of postoperative complication. Postoperative complication (P < 0.001, HR 4.132, 95%CI 2.217–7.692) was the independent risk factor for prolonged ICU stay. Conclusion Complete pericardiectomy was associated with high risk of postoperative complication in tuberculous constrictive pericarditis. Poor preoperative NYHA functional class and high preoperative CVP were shown to predict postoperative complication which was the predictor of prolonged ICU stay.

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Anterior Pericardiectomy for Postinfective Constrictive Pericarditis: Intermediate-Term Outcomes

Abstract: Anterior pericardiectomy is sufficient in patients with constrictive pericarditis of infective etiology. Preoperative low ejection fraction, atrial fibrillation, poor functional class, and constrictive effusive pericarditis results in poor surgical outcome.

Cited by 14 publications

References 8 publications

Fifteen-year experience with pericardiectomy at a tertiary referral center

Fifteen-year experience with pericardiectomy at a tertiary referral center

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

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