PMID- 23761416
OWN - NLM
STAT- MEDLINE
DCOM- 20140722
LR  - 20201216
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 44
IP  - 6
DP  - 2013 Dec
TI  - Constrictive pericarditis: risks, aetiologies and outcomes after total 
      pericardiectomy: 24 years of experience.
PG  - 1023-8; discussion 1028
LID - 10.1093/ejcts/ezt138 [doi]
AB  - OBJECTIVES: Constrictive pericarditis is the result of a spectrum of primary 
      cardiac and non-cardiac conditions. Few data exist on the preoperative risk 
      specific to survival after pericardiectomy. This study was designed to compare 
      the association of aetiology of constrictive pericarditis and other clinical 
      variables, with long-term survival after total pericardiectomy. METHODS: A total 
      of 89 patients were studied, who underwent pericardiectomy for constrictive 
      pericarditis at a single surgical centre between 1988 and 2012. Constrictive 
      pericarditis was confirmed by the surgical report. Demographic, pre-, intra- and 
      postoperative data and long-term outcome were investigated. Survival was assessed 
      by the Kaplan-Meier method. RESULTS: Aetiology of constrictive pericarditis was 
      idiopathic in 49 patients (55%), prior cardiac surgery in 21 patients (23.6%), 
      tuberculosis in 5 patients (5.6%), radiation treatment in 5 (5.6%), uraemia in 4 
      (4.5%), inflammation in 3 (3.5%) myocardial infarction in 2 (2.2%), and 
      perioperative mortality was 7%. Seventy-five percent of patients were in New York 
      Heart Association (NYHA) class III-IV, which status significantly improved in 
      long-term survivors (95% in NYHA I-II). Idiopathic constrictive pericarditis had 
      the best prognosis (5-year Kaplan-Meier survival: 81%) followed by post-surgical 
      (50%) and post-radiation pericarditis (no survivors after 5 years). Tuberculosis, 
      myocardial infarction and uraemia have survival rates comparable with idiopathic 
      aetiology. In addition, preoperative NYHA class IV was associated with 
      significantly lower long-term survival. CONCLUSIONS: Long-term survival after 
      pericardiectomy for constrictive pericarditis is related to underlying aetiology 
      and overall clinical condition. The relatively good survival with idiopathic 
      constrictive pericarditis emphasizes the safety of pericardiectomy in this 
      subgroup.
FAU - Szabo, Gabor
AU  - Szabo G
AD  - Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
FAU - Schmack, Bastian
AU  - Schmack B
FAU - Bulut, Cem
AU  - Bulut C
FAU - Soos, Pal
AU  - Soos P
FAU - Weymann, Alexander
AU  - Weymann A
FAU - Stadtfeld, Susanne
AU  - Stadtfeld S
FAU - Karck, Matthias
AU  - Karck M
LA  - eng
PT  - Journal Article
DEP - 20130612
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Surgical Procedures/adverse effects/*methods
MH  - Central Venous Pressure
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Pericarditis, Constrictive/*etiology/*surgery
MH  - Prognosis
OTO - NOTNLM
OT  - Constrictive/complications/surgery
OT  - Pericardiectomy
OT  - Pericarditis
OT  - Retrospective Studies
OT  - Treatment outcome
EDAT- 2013/06/14 06:00
MHDA- 2014/07/23 06:00
CRDT- 2013/06/14 06:00
PHST- 2013/06/14 06:00 [entrez]
PHST- 2013/06/14 06:00 [pubmed]
PHST- 2014/07/23 06:00 [medline]
AID - ezt138 [pii]
AID - 10.1093/ejcts/ezt138 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2013 Dec;44(6):1023-8; discussion 1028. doi: 
      10.1093/ejcts/ezt138. Epub 2013 Jun 12.