10 Years of Pericardiectomy at a Tertiary New Zealand Hospital: Clinical Characteristics and Outcomes

Abstract

Pericardiectomy is an effective treatment for pericardial constriction but is infrequently performed. This study assessed outcomes and clinical characteristics of a consecutive series of pericardiectomy patients. Clinical coding was used to identify all patients who had a pericardiectomy at a tertiary hospital between 2011 and 2021. Patients who had a pericardial window or partial pericardiectomy as part of tumour resection were excluded. Clinical data were collected from electronic medical records. Thirty-six patients met inclusion criteria: 30 were male, 23 NZ European, two Māori, and six Pacific Islanders. The mean age was 53.2 years (range 7–78). The aetiology of the pericardial disease was 17 idiopathic (47%), eight post-surgical (22%), three viral (8%), three tuberculosis (8%), two rheumatological (5%), two post-radiotherapy (5%), and one pyogenic (3%). Cardiopulmonary bypass was used in 20 patients (55%) with a median operative time of 189 minutes. Ten patients (28%) had concomitant cardiac surgery. The mean intensive care unit and hospital length of stay was 4.3 days and 11.7 days, respectively. Twenty-five patients (48%) required postoperative inotropic/vasopressor support. Mean New York Heart Association functional class was 2.3 before pericardiectomy and 1.6 postoperatively. Two patients (5%) died within the hospital admission, and three (8%) died during longer follow-up, with a mean follow-up of 5.4 years. Pericardiectomy was associated with a low to moderate risk of in-hospital and 5-year mortality. Functional status improved after surgery in most patients. Larger multicentre studies are needed to reliably identify predictors of short- and medium-term adverse outcomes in patients considered for pericardiectomy.