Atrio-ventricular regurgitations in constrictive pericarditis: incidence and post-operative outcome

Mantri, R.R.; Radhakrishnan, S.; Sinha, Nakul; Goel, Pravin K.; Bajaj, Rajiv; Bidwai, P. S.

doi:10.1016/0167-5273(93)90245-c

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…4,8 The operative mortality of 10.68% was comparable with other reports in the range of 4% to 18%. 2,3,7,10,11 The majority of patients improved by one or more functional classes, which compares favorably with the results of other investigators. [3][4][5] In agreement with earlier studies, preoperative NYHA functional class IV, left atrial size > 40 mm•m -2 , and inadequate pericardiectomy adversely affected the outcome.…”

Section: Discussionsupporting

confidence: 83%

Subtotal Pericardiectomy via Sternotomy for Constrictive Pericarditis

Srivastava¹,

Ganjoo²,

Misra³

et al. 2000

Asian Cardiovasc Thorac Ann

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Records of 103 patients with constrictive pericarditis who underwent subtotal pericardiectomy from January 1990 to December 1997 were retrospectively analyzed. The etiology of pericardial constriction was unknown in 63, tuberculous in 30, pyogenic in 7, and miscellaneous in 3 patients. Adequate pericardiectomy could be accomplished in 85 (82.5%) patients. Eleven patients (10.68%) died within 30 days of surgery. The 92 survivors were followed up for 47.21 ± 30.7 months; functional status improved in all cases. Of 15 variables examined by univariate logistic regression analysis, preoperative New York Heart Association functional class IV, atrial fibrillation, left atrial size > 40 mm·m−2, mild to moderate mitral regurgitation, tricuspid regurgitation, pericardial calcification, and inadequate pericardiectomy were found to be significant predictors of poor outcome. Adequate pericardiectomy via sternotomy was considered to carry low operative risk and provide excellent improvement in functional capacity.

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Section: Discussionsupporting

confidence: 83%

Subtotal Pericardiectomy via Sternotomy for Constrictive Pericarditis

Srivastava¹,

Ganjoo²,

Misra³

et al. 2000

Asian Cardiovasc Thorac Ann

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“…Several cases of worsening TR or right ventricular dysfunction after pericardiectomy have been reported [23–25]. Mantri et al concluded if an adequate pericardiectomy is done at an earlier stage, the regurgitations will regress [26]. Gongora et al [12] stated TR is relieved in only 29% of patients after pericardiectomy, and they recommended repair of the tricuspid valve because TR of more than a moderate grade increases late mortality.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of radical pericardiectomy for constrictive pericarditis in Korean population

Choi

Jeong

et al. 2019

J Cardiothorac Surg

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BackgroundThe extent of pericardiectomy is an important issue in constrictive pericarditis but its impact on long-term outcomes has been rarely reported. We compared long-term results of radical pericardiectomy with conventional phrenic to phrenic pericardiectomy.MethodsNinety patients who underwent pericardiectomies between February 1995 and April 2015 were reviewed retrospectively. They were classified into conventional (n = 37) and radical (n = 53) groups according to pericardiectomy being performed anterior or posterior to the phrenic nerves, respectively. The follow-up duration at outpatient clinic was 37.6 (11.7, 86.6) months and the survival data until 91.6 (54.5, 147.0) months were obtained. The last echocardiographies were done at 22.4 (4.35, 60.85) months.ResultsThe early mortality rate was 4.4% (4/90). They all belonged to the conventional group and died of low cardiac output syndrome. The survival rate was higher in the radical group (P = .032, 74.7 ± 9.2% versus 50.4 ± 11.9% in 20 years). NYHA class of both groups had recovered until the last follow-up but the radical group showed better recovery (P < .001). The conventional pericardiectomy (HR = 6.181; 95% CI (1.042, 36.656)), redosternotomy (HR = 6.441; 95% CI (1.224, 33.889) and preoperative grade of tricuspid regurgitation (HR = 15.003; 95% CI (1.099, 204.894) were associated with late mortality. Right ventricular systolic pressure decreased, and pericardial thickening resolved only in the radical group with significant intergroup differences as time went on. Tricuspid regurgitation worsened after the operation in both groups, but it deteriorated more in the conventional group. However, it improved over time in the radical group.ConclusionsRadical pericardiectomy led to greater improvement in right ventricular systolic pressure and lesser deterioration of tricuspid regurgitation with the passage of time than did the conventional procedure. Conventional pericardiectomy and preoperative higher grade tricuspid regurgitation were associated with long-term mortality.Electronic supplementary materialThe online version of this article (10.1186/s13019-019-0845-7) contains supplementary material, which is available to authorized users.

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“…Mantri et al, [5] constrictive pericarditis with TR or MR without repairing them. Long term follow-up resulted in regression of the regurgitation in half the cases.…”

Section: Discussionmentioning

confidence: 99%

Pericardiectomy for constrictive pericarditis with postoperative increase of tricuspid regurgitation

Taguchi¹,

Ishida²,

Mori³

et al. 2013

Cardio Vasc Syst

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We report a case of tricuspid regurgitation (TR) that increased markedly after pericardiectomy for constrictive pericarditis. Preoperative mild-to-moderate TR increased to severe following surgery. The patient was asymptomatic, and gradual regression of TR was observed. Eighteen months postoperatively, a left atrial thrombus formed, and a second surgery consisting of thrombectomy and tricuspid annuloplasty was performed. The increase in TR after pericardiectomy was thought to be due to dilatation of the right chambers and the annulus of the tricuspid valve. Several studies that entail mitral regurgitation after pericardiectomy are discussed.

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Atrio-ventricular regurgitations in constrictive pericarditis: incidence and post-operative outcome

Cited by 9 publications

References 15 publications

Subtotal Pericardiectomy via Sternotomy for Constrictive Pericarditis

Subtotal Pericardiectomy via Sternotomy for Constrictive Pericarditis

Long-term results of radical pericardiectomy for constrictive pericarditis in Korean population

Pericardiectomy for constrictive pericarditis with postoperative increase of tricuspid regurgitation

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