PMID- 38505028
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240321
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 16
IP  - 2
DP  - 2024 Feb 29
TI  - Early postoperative constrictive pericarditis in China: a single-center 
      retrospective observational study.
PG  - 1171-1179
LID - 10.21037/jtd-23-1186 [doi]
AB  - BACKGROUND: The diagnosis, treatment, and prognosis of early postoperative 
      constrictive pericarditis (EPCP) have not been discussed in depth. The objective 
      of this study was to devise and propose a management strategy for EPCP. METHODS: 
      In this study, constrictive pericarditis (CP) within 6 months after cardiac 
      surgery was defined as EPCP, and patients were divided into two groups based on 
      intraoperative findings: a parietal thickening group and a visceral thickening 
      group. RESULTS: A total of 20 patients were included in this study, and the 
      incidence rate of recurrent pericardiectomy was 0.32% among all patients 
      undergoing cardiovascular surgery. EPCP after valve surgery occurred in 85.0% of 
      patients. Pleural effusion was the most common preoperative symptom, occurring in 
      90% of patients. Pericardial thickening occurred in the visceral layer in seven 
      cases and in the parietal layer in 13 cases. There were no differences in 
      comorbidities, C-reactive protein (CRP) level, or erythrocyte sedimentation rate 
      (ESR) between the two groups. Most patients with visceral thickening (83.3%) 
      needed cardiopulmonary bypass (CPB) assistance during surgery and had a longer 
      hospital stay than those with parietal thickening (52.8+/-21.8 vs. 34.9+/-13.8 days, 
      P=0.049). Central venous pressure (CVP) was decreased in all patients after 
      pericardiectomy (24.9+/-6.96 vs. 8.9+/-2.92 cmH(2)O, P<0.001), and the cardiac 
      function improved significantly in patients with parietal thickening [New York 
      Heart Association (NYHA) grade >/= III accounted for 28.6% of patients]. The 
      long-term survival rate of patients with parietal thickening was 92.3% and that 
      of patients with visceral thickening was 57.1%, and there was no significant 
      difference between them (P=0.056). CONCLUSIONS: Recurrent episodes of chest 
      tightness, pleural effusion, and elevated CVP within 6 months after cardiac 
      surgery should be considered highly suggestive of EPCP. There are few points of 
      difference between pericarditis with thickening of the parietal and visceral 
      layers. After failure of conservative medical treatment, pericardiectomy results 
      in significant improvements in cardiac function and quality of life, especially 
      in patients with thickening of the parietal layer.
CI  - 2024 Journal of Thoracic Disease. All rights reserved.
FAU - Peng, Jianhui
AU  - Peng J
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Wang, He
AU  - Wang H
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Zhong, Keng
AU  - Zhong K
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Lu, Jie
AU  - Lu J
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Cai, Chengliang
AU  - Cai C
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Yang, Fan
AU  - Yang F
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Yu, Shangyi
AU  - Yu S
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Han, Lin
AU  - Han L
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Xu, Zhiyun
AU  - Xu Z
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
FAU - Zhang, Guanxin
AU  - Zhang G
AD  - Department of Cardiovascular Surgery, Changhai Hospital, The Naval Military 
      Medical University, Shanghai, China.
LA  - eng
PT  - Journal Article
DEP - 20240224
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC10944761
OTO - NOTNLM
OT  - Constrictive pericarditis (CP)
OT  - cardiac surgery
OT  - management strategies
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jtd.amegroups.com/article/view/10.21037/jtd-23-1186/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2024/03/20 06:45
MHDA- 2024/03/20 06:46
PMCR- 2024/02/29
CRDT- 2024/03/20 04:02
PHST- 2023/07/30 00:00 [received]
PHST- 2023/12/21 00:00 [accepted]
PHST- 2024/03/20 06:46 [medline]
PHST- 2024/03/20 06:45 [pubmed]
PHST- 2024/03/20 04:02 [entrez]
PHST- 2024/02/29 00:00 [pmc-release]
AID - jtd-16-02-1171 [pii]
AID - 10.21037/jtd-23-1186 [doi]
PST - ppublish
SO  - J Thorac Dis. 2024 Feb 29;16(2):1171-1179. doi: 10.21037/jtd-23-1186. Epub 2024 
      Feb 24.