Our Summary

This study looked at the outcomes of patients who had a surgery called a pericardiectomy after they received radiation treatments to the middle part of their chest. The surgery is meant to treat a condition called constrictive pericarditis, which can happen after radiation therapy. The researchers found that the surgery generally doesn’t have great outcomes for these patients in the long term. They studied 100 patients who had this surgery over a span of 17 years. The average age of the patients was around 57 years, and about half were women. About 10% of the patients died after the surgery, and common complications included needing ventilation for a long time, irregular heartbeat, and fluid in the lungs. The survival rate after 1 year was about 74%, after 5 years it was around 53%, and after 10 years it was about 32%. Older age seemed to make survival less likely. However, it seemed that the death rate right after surgery has been decreasing over time.

FAQs

  1. What is a pericardiectomy and why is it performed?
  2. What are the possible complications and mortality rates associated with pericardiectomy?
  3. Does age affect the survival rate of patients who undergo pericardiectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pericardiectomy is to closely follow post-operative care instructions and attend all follow-up appointments. This can help ensure proper healing and monitor for any complications that may arise. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help improve overall outcomes and recovery after surgery. It’s important to communicate any concerns or symptoms with your healthcare provider to address them promptly.

Suitable For

Patients who are typically recommended for pericardiectomy are those who have constrictive pericarditis, especially if it is a result of radiation therapy. These patients may have symptoms such as shortness of breath, fatigue, chest pain, and swelling in the abdomen or legs. It is important for patients to be evaluated by a cardiologist and a cardiothoracic surgeon to determine if they are good candidates for the surgery. Older age may be a risk factor for poorer outcomes, but the decision to undergo pericardiectomy should be made on a case-by-case basis considering the individual patient’s overall health and prognosis.

Timeline

Before the pericardiectomy:

  • Patient undergoes radiation therapy to the middle part of their chest
  • Develops constrictive pericarditis as a complication of the radiation therapy
  • Symptoms may include shortness of breath, chest pain, fatigue, and swelling in the legs
  • Patient is evaluated by a healthcare provider and a decision is made to proceed with a pericardiectomy

After the pericardiectomy:

  • Patient undergoes surgery to remove the rigid pericardium surrounding the heart
  • Recovery period in the hospital, which may involve ventilator support, monitoring for complications, and physical therapy
  • Follow-up appointments with healthcare providers to monitor recovery and manage any complications
  • Long-term outcomes may include improved symptoms and quality of life, but also potential complications such as irregular heartbeat, fluid in the lungs, and decreased survival rates over time
  • Continued monitoring and management of the patient’s condition to optimize their long-term outcomes and quality of life

What to Ask Your Doctor

  1. What is the reason for recommending a pericardiectomy in my case?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time after a pericardiectomy?
  4. Are there any alternative treatment options available for my condition?
  5. How many pericardiectomy surgeries have you performed, and what is your experience with this procedure?
  6. Will I need any additional treatments or therapies after the surgery?
  7. What is the long-term prognosis for patients who undergo a pericardiectomy?
  8. How will my quality of life be impacted after the surgery?
  9. Are there any lifestyle changes or restrictions I should follow post-surgery?
  10. What follow-up appointments and monitoring will be needed after the surgery?

Reference

Authors: Pahwa S, Crestanello J, Miranda W, Bernabei A, Polycarpou A, Schaff H, Dearani J, Stulak J, Pochettino A, Daly R, Lahr B, Viehman J, Greason K. Journal: J Card Surg. 2021 Dec;36(12):4636-4642. doi: 10.1111/jocs.15996. Epub 2021 Sep 21. PMID: 34547827