Echocardiographic parameters in clinical responders to surgical pericardiectomy – A single center experience with chronic constrictive pericarditis

Patil, Devendra V.; Sabnis, Girish; Phadke, Milind; Lanjewar, Charan; Mishra, Prashant; Kulkarni, Dwarkanath; Agrawal, Nandkishor; Kerkar, Prafulla

doi:10.1016/j.ihj.2015.09.027

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…The various echocardiographic parameters such as IVC congestion, mean LA size, mitral and tricuspid E velocity and TDI findings significantly improved in a study from central India comprising 23 patients of post-pericardiectomy. 17 In our study, there was significant respiro-phasic variation in the mitral and tricuspid E velocity in all patients ( P < 0.001). Tissue Doppler imaging (TDI) is a useful for distinguishing CCP from restrictive cardiomyopathy.…”

Section: Discussionsupporting

confidence: 51%

Short term clinical and echocardiography outcomes of pericardiectomy in constrictive pericarditis

Kumar

Padhy

Munjal

et al. 2021

J Cardiovasc Thorac Res

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Introduction: Tuberculous pericarditis continues to be a leading cause of chronic constrictive pericarditis (CCP) in developing countries. Echocardiography plays a key role in the assessment and diagnosis. Methods: Twelve patients who underwent pericardiectomy for CCP in last 18 months of the study period were subjected to clinical and New York Heart Association (NYHA) functional class assessment along with comprehensive echocardiographic evaluation. The data were compared with their preprocedural status. Results: Significant reduction was noted in the incidence of inferior vena cava (IVC) congestion(P < 0.001) and mean left atrial (LA) size from 43.75 ± 4.43 mm to 31.58 ± 3.03 mm (P < 0.001), post pericardiectomy.Respiratory variation of 34.17 ± 8.76 % in the mitral E velocity was significantly reduced to 17 ± 3.69 % (P < 0.001) after surgery. Similarly, respiratory variation in tricuspid E velocities showed significant reduction from 62.17 ± 13.16 % to 32.58 ± 4.7 % (P < 0.001).Prior to pericardiectomy, medial e’ and lateral e’ mitral annular velocities was 15.5±1.24 cm/sec and13.08 ± 1.08 cm/sec, respectively. Following surgery, the medial e’ and lateral e’ was 12.5±1.17 cm/sec(P = 0.001) and 15.42±1.83 (P = 0.004), respectively. Conclusion: Echocardiography provides useful insight in pericardial constriction hemodynamics and worthwhile effects of pericardiectomy.

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Section: Discussionsupporting

confidence: 51%

Short term clinical and echocardiography outcomes of pericardiectomy in constrictive pericarditis

Kumar

Padhy

Munjal

et al. 2021

J Cardiovasc Thorac Res

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“…The lateral e' did not change significantly before and after the operation, but the septal e' decreased after the operation. According to a report by Patil et al, post-operative septal bounce and respiratory variation in mitral and tricuspid E velocities are significantly improved, along with a decrease in septal e', resulting in improvement of "annulus reversus" [9]. These findings were also recognized in our case and are considered important evaluation factors for predicting post-operative prognosis.…”

Section: Discussionsupporting

confidence: 74%

Persistence of constrictive pattern despite improvement in symptoms after the waffle procedure: A case report of constrictive pericarditis

Minagawa

Ohara

Hasegawa

et al. 2020

Journal of Cardiology Cases

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Constrictive pericarditis (CP) is an uncommon disease characterized by clinical signs of right-sided heart failure subsequent to loss of pericardial compliance. Although pericardiectomy is the accepted treatment for improving cardiac hemodynamics in CP, some patients fail to improve after pericardiectomy. We herein report a case of CP that showed some physical and hemodynamic features with a constrictive pattern that persisted despite the improvement in heart failure symptoms after pericardiectomy. A 61year-old man was diagnosed with CP 7 months after the onset of symptoms of shortness of breath and edema in the legs. The waffle procedure was performed using an ultrasonic scalpel. Post-operative cardiac catheterization demonstrated a dip-and-plateau pattern in both right ventricular (RV) and left ventricular (LV) pressures, but the RV and LV end-diastolic pressures improved. Moreover, Doppler echocardiography showed an improvement in the change in mitral and tricuspid early velocities with respiration. Decrease in intraoperative right atrial pressure and respiratory variability in LV and RV inflow on echocardiography are important predictors of improvement in post-operative heart failure symptoms. Learning objective: Decrease in intraoperative right atrial pressure and respiratory variability in left ventricular and right ventricular inflow on post-operative echocardiography are important predictors of improvement in heart failure symptoms even if some hemodynamic features characterizing constrictive pericarditis (dip and plateau pattern, Friedreich's sign) persist.>

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“…Regarding the evolution of echocardiographic signs during the first post-operative year, the disappearance of constriction was noted in all patients (100%). A recent study [ 50 ] comparing the preoperative and postoperative echocardiography demonstrated a significant reduction in the congestion of the inferior vena cava from 100% to 15% of cases, a reduction in the size of the left atrium from 39.33±10.52 mm to 34.45±10.08 mm, a reduction in the paradoxical septum and respiratory variations in mitral inflow velocity. In our patients with preoperative RV dysfunction, improvement in RV function was noted in a single patient within 14 months.…”

Section: Discussionmentioning

confidence: 99%

Constrictive pericarditis: 21 years´ experience and review of literature

Taamallah¹,

Nesrine²,

Hatem³

et al. 2021

Pan Afr Med J

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To the best of our knowledge there are no publications about Tunisian experience in constrictive pericarditis (CP); the aim of this study was therefore to review our twenty-one years’ experience in terms of clinical and surgical outcomes and risk factors of death after pericardiectomy. An analytic bicentric and retrospective study carried out on 25 patients (20 male) with CP underwent pericardiectomy, collected over a 21-years period. The mean age was 40.46±16.74 years [7.5-72]. The commonest comorbid factor was tabagism (52%). The most common etiology was tuberculosis (n = 11, 44%). Dyspnea was the most common functional symptom (n = 21, 84%). Pericardiectomy was performed in all our patients within 2.9±3.19 months after confirmation of diagnosis. It was subtotal in 96% of cases. The commonest postoperative complications are pleural effusion (20%). Dyspnea was regressed within 1.8 months in 80% of cases and clinical signs of right heart failure within a mean duration of 1.62 months in 53% of cases. Perioperative mortality was 12% (3 deaths), late mortality was 4% (1 patient). Cardiopulmonary bypass, New York Heart Association (NYHA) over class II and right ventricular dysfunction are the prognostic factors of mortality (p = 0.001, 0.046, 0.019). Tuberculosis as etiology of CP had no impact on mortality. CP is a rare disease, with non-specific clinical signs. Pericardiectomy is effective with a significant improvement of the functional status of patients and favorable outcome at short and long term nevertheless hospital mortality is not negligible and depends on many factors.

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Echocardiographic parameters in clinical responders to surgical pericardiectomy – A single center experience with chronic constrictive pericarditis

Cited by 8 publications

References 18 publications

Short term clinical and echocardiography outcomes of pericardiectomy in constrictive pericarditis

Short term clinical and echocardiography outcomes of pericardiectomy in constrictive pericarditis

Persistence of constrictive pattern despite improvement in symptoms after the waffle procedure: A case report of constrictive pericarditis

Constrictive pericarditis: 21 years´ experience and review of literature

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