Chronic Constrictive Pericarditis (CCP) in Africa: Epidemiology, Etiology, Diagnosis, and Surgical Treatment

Abstract

Chronic constrictive pericarditis (CCP) is not rare in Africa with tuberculosis as the most common etiology. A long history of visceral tuberculosis, typical symptoms of CCP because of late clinical presentation in most cases, make diagnosis almost easy to establish. Echocardiography and cardiac catheterization may be helpful as final investigation when differentiation between CCP, endomyocardial fibrosis, and restrictive ventricular heart disease is difficult to attest. Pericardiectomy remains the only efficient treatment to carry out. We review the African teams' surgical experiences on pericardiectomy and report their surgical results and those worldwide in literature overall. In African groups, early mortality varies from 0 to 22% versus 2.1 to 18.6% outside Africa associated with New York Heart Association Functional Class IV as the most common significant risk factor for early deaths in all series in the World, including Africa.