PMID- 23841979
OWN - NLM
STAT- MEDLINE
DCOM- 20150213
LR  - 20140627
IS  - 1467-1107 (Electronic)
IS  - 1047-9511 (Linking)
VI  - 24
IP  - 4
DP  - 2014 Aug
TI  - Pericardiectomy in children <15 years of age.
PG  - 616-22
LID - 10.1017/S1047951113000814 [doi]
AB  - Between January, 2002 and December, 2011, 27 patients (19 boys) underwent 
      pericardiectomy. The mean age was 9.3 +/- 4.96 years (range 0.4 to 15 years) and 
      the mean duration of symptoms was 16.9 +/- 22.15 months. In all, 25 patients had 
      dyspnoea; eight were in New York Heart Association (NYHA) class IV; six had 
      bacterial pericarditis; and 18 were on anti-tuberculosis treatment, although only 
      nine had records suggesting tuberculosis. There were nine patients who underwent 
      pre-operative pigtail catheter drainage of pericardial fluid. Surgical procedures 
      were complete pericardiectomy (n = 20), partial pericardiectomy (n = 6), and 
      pleuropericardial window (n = 1).The mean pre-operative right atrial pressure was 
      20.4 +/- 4.93 mmHg. There were six hospital deaths due to low cardiac output (n = 
      5) and arrhythmia (n = 1). The mean intensive care unit stay was 2.7 +/- 1.2 days 
      and mean post-operative stay was 9.9 days. The mean right atrial pressure dropped 
      to 8.7 +/- 1.15 mmHg. Adverse outcomes defined as death/prolonged intensive care 
      unit stay, prolonged post-operative stay were not associated with sex, diagnosis 
      of tuberculosis or pyopericardium, or the duration of symptoms or pre-operative 
      right atrial pressure. Younger patients had prolonged intensive care unit stay (p 
      = 0.03) but not increased mortality. Advanced NYHA class predicted death (p = 
      0.02). The mean follow-up was 23.1 +/- 23.8 months. All except one survivor are in 
      NYHA class I and off all cardiac medications. Despite adequate surgery, 
      pericardiectomy in children is associated with a high mortality, which is related 
      to delayed surgery and poor pre-operative general condition. No specific 
      pre-operative variable other than worse pre-operative NYHA class is a predictor 
      of survival. Therefore, early pericardiectomy should be undertaken in such 
      patients.
FAU - Talwar, Sachin
AU  - Talwar S
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Nair, Vinitha Viswambharan
AU  - Nair VV
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Choudhary, Shiv Kumar
AU  - Choudhary SK
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Sreeniwas, Vishnubhatla
AU  - Sreeniwas V
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Saxena, Anita
AU  - Saxena A
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Juneja, Rajnish
AU  - Juneja R
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Kothari, Shyam Sunder
AU  - Kothari SS
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
FAU - Airan, Balram
AU  - Airan B
AD  - Cardiothoracic Center and Department of Biostatistics,All India Institute of 
      Medical Sciences,New Delhi,India.
LA  - eng
PT  - Journal Article
DEP - 20130710
PL  - England
TA  - Cardiol Young
JT  - Cardiology in the young
JID - 9200019
SB  - IM
MH  - Adolescent
MH  - Bacterial Infections/*surgery
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Infant
MH  - Length of Stay
MH  - Male
MH  - Pericardiectomy/*methods
MH  - Pericarditis/surgery
MH  - Pericarditis, Constrictive/*surgery
MH  - Pericarditis, Tuberculous/*surgery
MH  - *Postoperative Complications
MH  - Retrospective Studies
MH  - Time-to-Treatment
EDAT- 2013/07/12 06:00
MHDA- 2015/02/14 06:00
CRDT- 2013/07/12 06:00
PHST- 2013/07/12 06:00 [entrez]
PHST- 2013/07/12 06:00 [pubmed]
PHST- 2015/02/14 06:00 [medline]
AID - S1047951113000814 [pii]
AID - 10.1017/S1047951113000814 [doi]
PST - ppublish
SO  - Cardiol Young. 2014 Aug;24(4):616-22. doi: 10.1017/S1047951113000814. Epub 2013 
      Jul 10.