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ABSTRACT
Background. Constrictive pericarditis is the result of a spectrum of primary cardiac and non-cardiac conditions, resulting in impaired diastolic function. The purpose of this study was to evaluate the mid-term outcomes following treatment of constrictive pericarditis by pericardiectomy. Patients and methods. Between January 2010 and December 2019, patients who underwent pericardiectomy for constrictive pericarditis were retrospectively examined. All patients underwent pericardiectomy by median sternotomy, phrenic-to-phenic. Demographic, pre-, intra- and postoperative data and mid-term outcomes were analyzed. Results. A total of 25 patients with chronic constrictive pericarditis. The mean age was 39 ± 12.4 years, with 80 % of patients were males. Dyspnea was the most complaint symptoms. Seventy-eight percent of patients were in stage III-IV of NYHA, and most patients were idiopathic in 44.4 %. In hospital mortality was 4%, in malignancies aetiologies. Mean duration of the pericardiectomy was 125 ± 25.5 min. The mean preoperative central venous pressures was 18 ± 3.5 vs 9.5 ± 1.2 mm Hg postoperatively (p < 0.05). Postoperative complications noted were pleural effusion, long-term intubation, pulmonary infection, low cardiac output syndrome, bleeding. Late mortality rate was 8%, in the sub group of patients with malignancies. Mean follow-up time was 48 ± 24.5 months. The actuarial survival rates were 94 %, 88 % and 86 % at 1, 2 and 5 years, respectively. Conclusion. When performing early before onset of congestive symptoms, pericardiectomy might achieve to good results. Malignancies aetiologies usually had poor prognosis.


RÉSUMÉ
Introduction. La péricardite chronique constrictive peut être secondaire à une pathologie cardiaque ou extracardiaque, entrainant une dysfonction diastolique. L’objectif de ce travail était d’évaluer les résultats à mi-parcours d’une péricardectomie. Patients et méthodes. Entre janvier 2010 et décembre 2019, tout patient opéré pour péricardite chronique constrictive a été inclus. Elle se déroule par sternotomie médiane, et la résection s’est faite de manière phréno-phrénique. Les variables démographiques, préopératoires, postopératoires ont été analysées. Résultats. Vingt-cinq patients ont été opérés. L’âge moyen était de 39 ± 12.4 ans, avec 80 % de patient de sexe masculin. La dyspnée était la plainte principale. Soixante-dix-huit pourcents de patients étaient en stade III-IV de NYHA. L’étiologie idiopathique représentait 44,4 %. Mortalité hospitalière était de 4 %, chez les patients ayant un cancer. La durée moyenne de péricardectomie était de 125 ± 25.5 min. La pression veineuse centrale préopératoire était de 18 ± 3.5 vs 9.5 ± 1.2 mm Hg (p < 0.05). Les complications postopératoires ont été : pleurésie, infection pulmonaire, bas débit cardiaque, intubation prolongée, saignement. Mortalité à moyen terme était de 8 %, chez les patients ayant un cancer. La durée moyenne de suivi 48 ± 24.5 mois. Le taux de survie était de 98%, 88%, et 86%, respectivement à un an, deux, et cinq ans. Conclusion. La péricardectomie donne d’excellents résultats quand elle est réalisée avant la survenue des signes de congestion. L’étiologie cancéreuse présente un pronostic péjoratif.

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Sayah, R. ., Atipo-galloye, R., Moumpala, S., & Tseyi Ossere, B. . (2022). Mid-Term Outcome of Pericardiectomy for Chronic Constrictive Pericarditis. HEALTH SCIENCES AND DISEASE, 23(2). https://doi.org/10.5281/hsd.v23i2.3354
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