Pericardiectomy for Constrictive Pericarditis - A Comprehensive Study Between Total and Subtotal Pericardiectomy by Left Aterolateral Thoracotomy
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 4
Abstract
Introduction: Constrictive pericarditis is a chronic inflammatory process that leads to progressive pericardial fibrosis encasing the heart in a thickened and fibrotic pericardiectomy this leads to impaired diastolic filling of the cardiac chambers, with the elevation of right atrial mean pressure and end diastolic pressure in both ventricles with the end result of reduced cardiac output. Aim: To analyze the perspectives of clinical outcomes and surgical results of pericardiectomy (total or subtotal) done by left anterolateral thoracotomy and to analyze the histopathology of all pericardiectomy specimen to find out the etiology. Methods: The patient population consisted of patients with constrictive pericarditis who had pericardiectomy and confirmed pathologically. Patients were assigned into two groups one with sub-total pericardiectomy (Group I) and lie other with total pericardiectomy (Group II). Results: The mortality rate was similar in the two Groups with two deaths. All the deaths were cardiac related and occur in the perioperative period as a result of low cardiac syndrome. Both the groups of the patients had similar arid significant improvement in the New York Heart Association (NYHA) status. The degree of improvement was not significant improvement between the two groups. The mean hospital stay and inotropic support requirements was similar between the two groups. It is of interest to note that 40% of cases are caused by tuberculosis and no obvious cause of pericarditis was identified in the rest of the patients in both the groups. Conclusion: The results of pericardiectomy in terms of improvement in NYHA status and mortality are similar in both types of resection. The combination of chemotherapy and surgery yields good results in the treatment of tuberculous pericarditis.
Authors and Affiliations
G Josephraj, P Rani, M Muthukumar, S Naveen, Heber Anandan
Keywords
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