PMID- 27904840
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2223-3652 (Print)
IS  - 2223-3660 (Electronic)
IS  - 2223-3652 (Linking)
VI  - 6
IP  - Suppl 1
DP  - 2016 Oct
TI  - Surgical experience on chronic constrictive pericarditis in African setting: 
      review of 35 years' experience in Cote d'Ivoire.
PG  - S13-S19
AB  - BACKGROUND: Surgical experience with chronic constrictive pericarditis (CCP) is 
      rarely documented in Africa; the aim of this study is therefore to review our 
      African experience with CCP from 1977 to 2012 in terms of clinical and surgical 
      outcomes and risk factors of early death after pericardiectomy. METHODS: This 
      retrospective study is related to 120 patients with CCP; there were 72 men and 48 
      women with an average age at 28.8+/-10.4 years standard deviation (SD) (8-51 
      years). The main etiology was tuberculosis (99%). Symptoms secondary to systemic 
      venous congestion were always present: patient were functionally classified 
      according New York Heart Association (NYHA) functional classification: 63 
      patients presented in class II NYHA and 57 in class III or IV NYHA. The diagnosis 
      confirmed by surgical report was: sub-acute CCP (n=12; 10%), fibrous CCP (n=36; 
      30%), calcified CCP (n=72; 60%). A pericardiectomy including an epicardiectomy 
      with a systematic release of the ventricles was carried out in every case. Median 
      sternotomy was frequently performed (n=117; 97.5%). RESULTS: Fifteen early deaths 
      (12.5%) were observed, the cause of hospital deaths was due to a low cardiac 
      output (n=12) and to a hepatic failure (n=3). Class III or IV (NYHA) (P=0.01), 
      mitral regurgitation (P<0.05), persistent a diastolic syndrome after surgery 
      (P<0.05) and low cardiac index (CI) (P<0.02) were the important risk factors. 
      Age, size of cardiac X-ray silhouette, right and left ventricular diastolic 
      pressures, ejection fraction (EF), atrial fibrillation and pericardial 
      calcifications had no impact on early survival. The average follow up was 4 years 
      (1-10 years); we lost 22 patients during follow-up. Among survivors, there was no 
      late death; the patients were in class I or II NYHA. Post-operative 
      catheterization evaluation (n=30) shown a significant decrease of the right and 
      left ventricular end-diastolic pressures (P<0.05), of the pulmonary capillary 
      wedge pressure (PCWP) (P<0.05) and of the right atrial pressure (RAP) (P<0.05) 
      and a disappearance of the lack of ventricular diastolic distensibility. 
      CONCLUSIONS: Based on our experience, CCP surgery can be performed safely with an 
      acceptable hospital mortality and a significant improvement of patients' 
      functional status at long term after surgery.
FAU - Yangni-Angate, Koffi Herve
AU  - Yangni-Angate KH
AD  - Department of Cardio-Vascular and Thoracic Surgery, Bouake Teaching Hospital, 
      Bouake, Cote d'Ivoire.
FAU - Tanauh, Yves
AU  - Tanauh Y
AD  - Department of Thoracic Surgery, Institute of Cardiology of Abidjan, Abidjan, Cote 
      d'Ivoire.
FAU - Meneas, Christophe
AU  - Meneas C
AD  - Department of Cardio-Vascular and Thoracic Surgery, Bouake Teaching Hospital, 
      Bouake, Cote d'Ivoire.
FAU - Diby, Florent
AU  - Diby F
AD  - Department of Cardio-Vascular and Thoracic Surgery, Bouake Teaching Hospital, 
      Bouake, Cote d'Ivoire.
FAU - Adoubi, Anicet
AU  - Adoubi A
AD  - Department of Cardio-Vascular and Thoracic Surgery, Bouake Teaching Hospital, 
      Bouake, Cote d'Ivoire.
FAU - Diomande, Manga
AU  - Diomande M
AD  - Department of Cardio-Vascular and Thoracic Surgery, Bouake Teaching Hospital, 
      Bouake, Cote d'Ivoire.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Cardiovasc Diagn Ther
JT  - Cardiovascular diagnosis and therapy
JID - 101601613
PMC - PMC5120001
OTO - NOTNLM
OT  - Chronic constrictive pericarditis (CCP)
OT  - pericardiectomy
OT  - pericardium
COIS- The authors have no conflicts of interest to declare.
EDAT- 2016/12/03 06:00
MHDA- 2016/12/03 06:01
PMCR- 2016/10/01
CRDT- 2016/12/02 06:00
PHST- 2016/12/02 06:00 [entrez]
PHST- 2016/12/03 06:00 [pubmed]
PHST- 2016/12/03 06:01 [medline]
PHST- 2016/10/01 00:00 [pmc-release]
AID - cdt-06-S1-S13 [pii]
AID - 10.21037/cdt.2016.09.06 [doi]
PST - ppublish
SO  - Cardiovasc Diagn Ther. 2016 Oct;6(Suppl 1):S13-S19. doi: 10.21037/cdt.2016.09.06.