Our Summary

This study looks at the long-term outcomes of 47 patients who underwent surgery to treat constrictive pericarditis - a rare disease that causes the sac around the heart to thicken and harden, making it difficult for the heart to function properly. The surgery, called pericardiectomy, involves removing the hardened sac.

The patients were studied between 1992 and 2014. Most of the patients were men, with an average age of around 46 years. The most common cause of their disease was tuberculosis, followed by unknown causes and cancer.

All of the surgeries were done through a cut down the middle of the chest, except for one case. The average surgery time was around 2.5 hours. After surgery, 80% of patients showed some improvement in their heart function. However, one patient died in hospital due to pneumonia and a further 11 patients died during the follow-up period, which averaged around five years. The chances of surviving for 1, 5 and 10 years after the operation were 91%, 85% and 81% respectively.

The study concludes that this surgery comes with high risks of complications and death. Patients with cancer, poor heart function, or those needing a repeat operation are more likely to die and less likely to recover their heart function fully.

FAQs

  1. What is pericardiectomy and why is it performed?
  2. What were the long-term outcomes of the patients who underwent pericardiectomy in this study?
  3. Who are more likely to face complications or death after pericardiectomy surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about pericardiectomy is to closely follow post-operative care instructions, including taking prescribed medications, attending follow-up appointments, and engaging in cardiac rehabilitation programs to optimize recovery and improve long-term outcomes. It is also important to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support heart health after surgery. Additionally, being aware of potential complications and seeking prompt medical attention if any symptoms arise is crucial for a successful recovery.

Suitable For

Patients who are typically recommended for pericardiectomy are those with constrictive pericarditis that is causing significant symptoms and affecting their heart function. These patients may have symptoms such as shortness of breath, fatigue, fluid retention, and chest pain. They may have tried other treatments such as medications or pericardiocentesis (draining fluid from around the heart) without success.

Patients with a clear diagnosis of constrictive pericarditis, confirmed through imaging tests such as echocardiography, cardiac MRI, or CT scan, are good candidates for pericardiectomy. They should also be in overall good health and able to tolerate surgery.

Patients with certain underlying causes of constrictive pericarditis, such as tuberculosis, may also be more likely to benefit from pericardiectomy. However, the decision to undergo surgery should be made on a case-by-case basis, taking into account the patient’s overall health, extent of the disease, and potential risks and benefits of surgery.

Timeline

Before pericardiectomy, patients may experience symptoms such as chest pain, shortness of breath, fatigue, and swelling in the abdomen and legs. They may undergo tests such as echocardiograms, CT scans, and MRI scans to diagnose constrictive pericarditis and determine if surgery is necessary.

After pericardiectomy, patients may experience a period of recovery in the hospital, where they will be monitored closely for any complications. They may need to take medications to manage pain and prevent infection. Over time, they may gradually regain their strength and ability to perform daily activities.

Long-term outcomes after pericardiectomy can vary, with some patients experiencing improvement in their heart function and quality of life, while others may face complications or even death. Regular follow-up appointments with a cardiologist are important to monitor the patient’s progress and address any concerns that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pericardiectomy surgery?
  2. How long is the recovery period after pericardiectomy surgery?
  3. What can I expect in terms of improvement in my heart function after the surgery?
  4. Are there any alternative treatments or therapies available for constrictive pericarditis?
  5. How often will I need follow-up appointments after the surgery?
  6. What lifestyle changes or medications may be necessary after pericardiectomy surgery?
  7. Are there any specific symptoms or signs I should watch for that may indicate a complication after surgery?
  8. How experienced is the surgical team in performing pericardiectomy procedures?
  9. Are there any specific factors in my medical history that may impact the success of the surgery?
  10. What is the long-term prognosis for patients who undergo pericardiectomy surgery?

Reference

Authors: Biçer M, Özdemir B, Kan İ, Yüksel A, Tok M, Şenkaya I. Journal: J Cardiothorac Surg. 2015 Nov 27;10:177. doi: 10.1186/s13019-015-0385-8. PMID: 26613929