PMID- 33845948
OWN - NLM
STAT- MEDLINE
DCOM- 20211012
LR  - 20211012
IS  - 0019-5707 (Print)
IS  - 0019-5707 (Linking)
VI  - 68
IP  - 2
DP  - 2021 Apr
TI  - Surgical treatment of tuberculous chronic constrictive pericarditis: A 
      retrospective observational study from tertiary hospital of eastern Nepal.
PG  - 174-178
LID - S0019-5707(20)30130-X [pii]
LID - 10.1016/j.ijtb.2020.08.002 [doi]
AB  - BACKGROUND: Tuberculosis remains an important cause of chronic constrictive 
      pericarditis (CCP) in developing countries. It is a surgically treatable cause of 
      diastolic heart failure. Without surgery, it is associated with high morbidity 
      and mortality. METHODS: We conducted a retrospective observational study of 
      clinical presentations and perioperative outcomes of pericardiectomy in all 
      patients operated from July 2015 to December 2018 for tuberculous CCP. RESULTS: A 
      total 14 patients (mean age - 38 +/- 13.3 years, 10 male), underwent 
      pericardiectomy via median sternotomy without cardiopulmonary bypass. Eleven 
      patients (79%) had completed treatment for pulmonary tuberculosis, and three 
      (21%) were on anti-tubercular treatment at the time of referral for surgery. Ten 
      patients (71%) had prior hospitalisation for cardiac failure. At the time of 
      surgery, eight patients (57%) were in New York Heart Association (NYHA) class 
      III-IV. The median duration of symptoms before surgical intervention was 15 
      months (range 11-24 months). Three patients (21%) had associated cardiac 
      cirrhosis. Twelve patients (86%) underwent total pericardiectomy. Two patients 
      (14%) underwent partial pericardiectomy. The mean operative time was 160 +/- 33.8 
      minutes. The mean central venous press pressure before and after surgery were 
      28 +/- 3.9 and 10 +/- 2 mmHg respectively. The mean intensive care unit (ICU) and 
      hospital stays were 4 +/- 1.5 and 10 +/- 2 days respectively. There was one (7%) 
      30-day mortality. There were two deaths (14%) due to non-cardiac causes at 10 and 
      16 months respectively. The remaining 11 patients (79%) are doing well (mean 
      follow-up- 23 months), and are in NYHA class I. CONCLUSIONS: Tuberculosis is the 
      most common cause of CCP in our region. Pericardiectomy provides definitive 
      treatment to alleviate symptoms resolution and improve survival.
CI  - Copyright (c) 2020 Tuberculosis Association of India. Published by Elsevier B.V. 
      All rights reserved.
FAU - Jaiswal, Lokesh Shekher
AU  - Jaiswal LS
AD  - Department of Surgery, B P Koirala Institute of Health Sciences (BPKIHS), Nepal. 
      Electronic address: lokesh_shekher@yahoo.com.
FAU - Pandit, Narendra
AU  - Pandit N
AD  - Department of Surgery, B P Koirala Institute of Health Sciences (BPKIHS), Nepal.
FAU - Sah, Bijay
AU  - Sah B
AD  - Department of Surgery, B P Koirala Institute of Health Sciences (BPKIHS), Nepal.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200808
PL  - India
TA  - Indian J Tuberc
JT  - The Indian journal of tuberculosis
JID - 0373027
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Adult
MH  - Antitubercular Agents
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Male
MH  - Nepal
MH  - Pericardiectomy
MH  - Pericarditis, Constrictive/*surgery
MH  - Retrospective Studies
MH  - Tertiary Care Centers
MH  - Treatment Outcome
MH  - *Tuberculosis, Pulmonary
OTO - NOTNLM
OT  - Chronic
OT  - Constrictive
OT  - Pericardiectomy
OT  - Pericarditis
OT  - Tuberculous
COIS- Conflicts of interest All authors have none to declare.
EDAT- 2021/04/14 06:00
MHDA- 2021/10/13 06:00
CRDT- 2021/04/13 05:42
PHST- 2020/05/06 00:00 [received]
PHST- 2020/07/13 00:00 [revised]
PHST- 2020/08/03 00:00 [accepted]
PHST- 2021/04/13 05:42 [entrez]
PHST- 2021/04/14 06:00 [pubmed]
PHST- 2021/10/13 06:00 [medline]
AID - S0019-5707(20)30130-X [pii]
AID - 10.1016/j.ijtb.2020.08.002 [doi]
PST - ppublish
SO  - Indian J Tuberc. 2021 Apr;68(2):174-178. doi: 10.1016/j.ijtb.2020.08.002. Epub 
      2020 Aug 8.