Our Summary

This research paper is about a study done on 10 patients who had chronic pericarditis, an inflammation of the pericardium (the sac-like covering around the heart). They were treated with a surgical procedure called radical pericardiectomy using an ultrasonic scalpel - a tool that uses sound waves to cut and remove the diseased part of the pericardium.

The patients’ ages ranged around 65 years, and 3 of them were female. Some had other heart-related issues like irregular heart beat or required urgent surgery. The ultrasonic scalpel was used to remove the diseased pericardium except in one specific area near the left atrium. In some cases, the surgery was performed while the heart was still beating (off-pump technique) and some needed additional procedures like bypass surgery or valve repair.

This treatment method resulted in no deaths during surgery. However, two patients experienced complications after surgery, one with an infection and another with kidney injury. One patient passed away from a stroke during the follow-up period. The rest of the patients recovered well and showed improvement in their heart function.

In conclusion, the study suggests that using an ultrasonic scalpel for this type of surgery can be effective in treating chronic pericarditis.

FAQs

  1. What is the purpose of using an ultrasonic scalpel in a radical pericardiectomy?
  2. What were some of the complications experienced by patients following the surgical procedure?
  3. What were the overall results of the study regarding the effectiveness of the ultrasonic scalpel in treating chronic pericarditis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to follow post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and engaging in cardiac rehabilitation if recommended. It is also important to monitor any symptoms or signs of infection, such as fever or redness/swelling at the surgical site, and to seek medical attention promptly if any concerns arise. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support recovery and overall heart health.

Suitable For

This procedure may be recommended for patients with chronic pericarditis who have not responded to other treatments, have recurrent symptoms, or have complications such as constrictive pericarditis. Patients who are relatively young and have good overall health are typically considered good candidates for pericardiectomy. It is important for patients to be evaluated by a cardiologist and a cardiac surgeon to determine if pericardiectomy is the best treatment option for their specific condition.

Timeline

Patients who are candidates for pericardiectomy typically experience symptoms such as chest pain, shortness of breath, and fatigue due to the inflammation of the pericardium. They undergo various diagnostic tests such as echocardiograms, CT scans, and MRI scans to confirm the diagnosis and assess the extent of the inflammation.

Before the surgery, patients may undergo medical management to control symptoms and reduce inflammation. They may also receive counseling on the risks and benefits of the surgery. The surgery itself involves the removal of the diseased pericardium using an ultrasonic scalpel, with or without additional procedures depending on the patient’s specific condition.

After the surgery, patients are closely monitored in the hospital for any complications such as infection, bleeding, or kidney injury. They may require post-operative care in the intensive care unit or a step-down unit depending on their recovery progress. Following discharge from the hospital, patients will require regular follow-up appointments with their healthcare team to monitor their recovery and assess their heart function.

Overall, the timeline of a patient’s experience before and after pericardiectomy involves pre-operative evaluation, surgery, post-operative monitoring, and long-term follow-up to ensure a successful recovery and improved heart function.

What to Ask Your Doctor

  1. What is the success rate of pericardiectomy using an ultrasonic scalpel for treating chronic pericarditis?
  2. What are the potential complications or risks associated with this surgical procedure?
  3. How long is the recovery period after undergoing a pericardiectomy?
  4. Will I need any additional procedures, such as bypass surgery or valve repair, in conjunction with the pericardiectomy?
  5. How will my heart function be monitored and evaluated post-surgery?
  6. Are there any long-term effects or considerations I should be aware of after undergoing this procedure?
  7. What is the likelihood of the chronic pericarditis returning after pericardiectomy?
  8. Are there any lifestyle changes or medications I should consider post-surgery to optimize my heart health?
  9. How frequently will follow-up appointments be required after the surgery?
  10. Are there any alternative treatment options for chronic pericarditis that I should consider before opting for pericardiectomy?

Reference

Authors: Yoshinaga T, Takaki J, Nakata K, Hirota T, Hidaka H, Horibe T, Okamoto K, Fukui T. Journal: Interdiscip Cardiovasc Thorac Surg. 2025 Feb 5;40(2):ivaf025. doi: 10.1093/icvts/ivaf025. PMID: 39921894