Pericardiectomy for constrictive pericarditis: single-center experience in China

详细信息    查看全文

• 作者：Peng Zhu ; Mingjie Mai ; Ruobin Wu ; Cong Lu ; Ruixin Fan…
• 关键词：Constrictive pericarditis ; Pericardiectomy ; Surgery ; Prognosis
• 刊名：Journal of Cardiothoracic Surgery
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：10
• 期：1
• 全文大小：503 KB
• 参考文献：1. Brockington, GM, Zebede, J, Pandian, NG (1990) Constrictive pericarditis. Cardiol Clin 8: pp. 645-61
  2. Tokuta, Y, Miyata, H, Motomura, N, Araki, Y, Oshima, H, Usui, A (2013) Outcome of pericardiectomy for constrictive pericarditis in Japan: A nationwide outcome study. Ann Thorac Surg 96: pp. 571-576 CrossRef
  3. George, TJ, Arnaoutakis, GJ, Beaty, CA, Kilic, A, Baumgartner, WA, Conte, JV (2012) Contemporaryaetilogies, risk factors and outcomes after pericardiectomy. Ann Thorac Surg 94: pp. 445-51 CrossRef
  4. Glenn, F, Diethelm, A (1962) Surgical treatment of constrictive pericarditis. Ann Surg 155: pp. 883-93 CrossRef
  5. Sengupta, PP, Eleid, MF, Khandheria, BK (2008) Constrictive pericarditis. Circ J 72: pp. 1555-62 CrossRef
  6. Gopaldas, RR, Dao, TK, Caron, NR, Markley, JG (2013) Predictors of in-hospital complications after pericardiectomy: a nationwide outcomes study. J Thorac Cardiovasc Surg 145: pp. 1227-33 CrossRef
  7. Lin, YY, Zhou, M, Xiao, J, Wang, B, Wang, ZN (2012) Treating constrictive pericarditis in a Chinese single-center study: a five-year experience. Ann Thoarc Surg 94: pp. 1235-40 CrossRef
  8. Ling, LH, Oh, JK, Schaff, HV, Danielson, GK, Mahoney, DW, Seward, JB (1999) Constrictive pericarditis in the modern era evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation 100: pp. 1380-86 CrossRef
  9. Chowdhury, UK, Subramaniam, GK, Kumar, AS, Airan, B, Singh, R, Taiwar, S (2006) Pericardiectomy for constrictive pericarditis:a clinical, echocardiographic, and hemodynamic evaluation of two surgical techniques. Ann Thorac Surg 81: pp. 522-29 CrossRef
  10. Ghavidel, AA, Gholampour, M, Kyavar, M, Mirmeshdag, Y (2012) Constrictive pericarditis treated by surgery. Tex Heart Inst J 39: pp. 199-205
  11. Skubas, NJ, Beardslee, M, Barzilai, B, Pasque, M, Kattapuram, M, Lappas, DG (2001) Constrictivepericarditis:intraoperative hemodynamic and echocardiographic evaluation of cardiac filling dynamics. AnesthAnalg 92: pp. 1424-26
  12. Schwefer, M, Aschenbach, R, Heidemann, J, Mey, C, Lapp, H (2009) Constrictive pericarditis, still a diagnostic challenge: comprehensive review of clinical management. Eur J Cardiothorac Surg 36: pp. 502-10 CrossRef
  13. Talreja, DR, Edwards, WD, Danielson, GK, Schaff, HV, Tajik, AJ, Tazelaar, HD (2003) Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation 108: pp. 1852-57 CrossRef
  14. Tirilomis, T, Unverdorben, S, von der Emde, J (1994) Pericardiectomy for chronic constrictive pericarditis:risks and outcome. Eur J Cardiothorac Surg 8: pp. 487-92 CrossRef
  
• 刊物主题：Cardiac Surgery; Thoracic Surgery;
• 出版者：BioMed Central
• ISSN：1749-8090

文摘

Objective Pericardiectomy is associated with a high prevalence of morbidity and mortality. We evaluated the predictors of in-hospital complications and outcome for pericardiectomy procedure for patients with constrictive pericarditis (CP) in a single-center in China. Methods One-hundred sixty-five patients who underwent pericardiectomy for CP between January 1990 and December 2012 at our hospital were evaluated. Results The mean age of the study cohort was 36.79?±-8.52?years. The approach was through a median sternotomy in 91.5% of patients. Cardiopulmonary bypass was used in 14.5% (24/165 patients). Unadjusted rates of mortality and complication were approximately 5.4% and 23%, respectively. The main cause of death was severe low cardiac output syndrome. Major complications were postoperative low cardiac output syndrome, reoperation for bleeding, pneumonia, mediastinitis, chylothorax and cerebral infarction. One-year survival was 92%. One-year follow-up revealed that New York Heart Association functional class III or IV, age, intraoperative use of cardiac pulmonary bypass and hemodialysis were associated with increased mortality and morbidity. Conclusions Total pericardiectomy is associated with lower perioperative and late mortality, and the extent of pericardial resection should be decided according to individual conditions. Perioperative management and complete release of the thickened pericardium of the left ventricle should prevent postoperative complications.