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Subtotal Pericardiectomy Via Sternotomy for Constrictive Pericarditis

Department of Cardiac Surgery 1 Department of Cardiology 2 Department of Biostatistics Sanjay Gandhi Post-Graduate Institute of Medical Sciences Lucknow, India

For reprint information contact: Ashok K Srivastava, MCh Tel: 91 522 44 0900 Ext. 2204 Fax: 91 522 44 0017 email: ashok{at}sgpgi.ac.in Department of Cardiac Surgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow 226014, India.

Records of 103 patients with constrictive pericarditis who underwent subtotal pericardiectomy from January 1990 to December 1997 were retrospectively analyzed. The etiology of pericardial constriction was unknown in 63, tuberculous in 30, pyogenic in 7, and miscellaneous in 3 patients. Adequate pericardiectomy could be accomplished in 85 (82.5%) patients. Eleven patients (10.68%) died within 30 days of surgery. The 92 survivors were followed up for 47.21 ± 30.7 months; functional status improved in all cases. Of 15 variables examined by univariate logistic regression analysis, preoperative New York Heart Association functional class IV, atrial fibrillation, left atrial size > 40 mm•m^–2, mild to moderate mitral regurgitation, tricuspid regurgitation, pericardial calcification, and inadequate pericardiectomy were found to be significant predictors of poor outcome. Adequate pericardiectomy via sternotomy was considered to carry low operative risk and provide excellent improvement in functional capacity.

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