Ten Years Experience with Pericardiectomy

Abstract

A retrospective analysis was made of the records of 62 patients who underwent pericardiectomy over a ten year period (1985 to 1996) in our department. Primarily, 43 patients (69.4%) had tuberculosis, 16 patients (25.8%) were diagnosed as idiopathic or viral infection, 2 patients (3.2%) had a previous cardiac operation and 1 patient (1.6%) had a neoplasm. Eight patients were in New York Heart Association functional class I, 22 in class II, 24 in class III, and 8 in class IV. Pericardiectomy was performed through midline sternotomy in all cases; 2 required cardiopulmonary bypass. Subtotal pericardiectomy was performed, in which the phrenic nerves define the posterior extent of pericardial resection. Low cardiac output was present in 8 patients. The early mortality rate was 6.45% (4 patients). During the follow-up period, ranging from 1 to 7 years (mean 3.8 ± 1.42 years), there were 2 late deaths due to the right heart failure. One patient who underwent pericardiectomy after an open-heart operation showed recurrent pericardial constriction. We conclude that pericardiectomy using midline sternotomy with or without cardiopulmonary bypass can be performed with low mortality and can result in good long-term survival and improved functional capacity.