Our Summary

This research paper looked at the risk factors that could lead to multiple organs failing after a patient has had a pericardiectomy, which is a surgical procedure to remove part or all of the pericardium (the sac that surrounds the heart). The study included 826 patients who had this surgery between 1994 and 2021 in three different hospitals.

The researchers divided the patients into two groups: those who experienced multiorgan failure after the surgery (86 patients or 10.4% of the total) and those who did not (740 patients). Among these patients, 66 died after their operations, and the causes of death were all due to multiorgan failure combined with other complications.

The study identified several factors that were associated with a higher risk of multiorgan failure. These included being male, the time between when symptoms first appeared and when the surgery occurred, the thickness of the pericardium, how long the patient had to be intubated and stay in the ICU, the time spent in the hospital after the surgery, measures of fluid balance and blood pressure before and after the surgery, blood loss during the surgery, and levels of certain substances in the blood after the surgery.

The study concluded that not removing enough of the pericardium during the surgery, having too much fluid in the body, and delays in diagnosing and treating the condition were all associated with a higher risk of multiorgan failure after a pericardiectomy.

FAQs

  1. What is a pericardiectomy and why is it performed?
  2. What factors were identified in the study that increase the risk of multiorgan failure after a pericardiectomy?
  3. What percentage of patients in the study experienced multiorgan failure after pericardiectomy surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to closely follow all post-operative instructions, including monitoring fluid intake and any signs of infection or complications. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider promptly. Additionally, maintaining a healthy lifestyle and following a heart-healthy diet can help support a successful recovery after pericardiectomy.

Suitable For

Pericardiectomy is typically recommended for patients who have constrictive pericarditis, a condition where the pericardium becomes thickened and rigid, restricting the heart’s ability to pump blood effectively. Patients with severe symptoms such as shortness of breath, chest pain, fatigue, and fluid retention are often considered for pericardiectomy.

Additionally, patients who do not respond to medical management or who experience complications such as heart failure, arrhythmias, or recurrent pericardial effusions may also be recommended for pericardiectomy. Patients with tumors or infections involving the pericardium may also require surgical removal of the affected tissue.

Overall, pericardiectomy is typically recommended for patients who have significant symptoms or complications related to their pericardial disease and who have not responded to conservative treatments. It is important for patients to undergo a thorough evaluation by a cardiologist or cardiothoracic surgeon to determine if pericardiectomy is the most appropriate treatment option for their specific condition.

Timeline

Before a pericardiectomy:

  • Patient experiences symptoms such as chest pain, shortness of breath, and fatigue
  • Diagnostic tests such as echocardiogram, MRI, and CT scan are performed to confirm the diagnosis of constrictive pericarditis
  • Patient undergoes pre-operative evaluations and consultations with the surgical team
  • Surgery is scheduled and patient is admitted to the hospital

After a pericardiectomy:

  • Patient undergoes the surgical procedure to remove part or all of the pericardium
  • Patient is monitored in the ICU for a period of time post-surgery
  • Patient may require intubation and mechanical ventilation
  • Patient stays in the hospital for a period of time for recovery
  • Patient is monitored for any complications such as multiorgan failure
  • Patient undergoes follow-up appointments and tests to monitor recovery and assess any potential complications

Overall, the timeline for a patient before and after a pericardiectomy involves diagnostic tests, surgical preparation, the surgical procedure itself, post-operative monitoring, and recovery. The risk of multiorgan failure after a pericardiectomy is associated with various factors, and close monitoring and timely intervention are important for patient outcomes.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about pericardiectomy:

  1. What are the potential risks and complications associated with pericardiectomy?
  2. What are the factors that could increase my risk of experiencing multiorgan failure after the surgery?
  3. How will you determine the amount of pericardium that needs to be removed during the surgery?
  4. How will you monitor my fluid balance and blood pressure before and after the surgery?
  5. What measures will be taken to prevent delays in diagnosing and treating any complications that may arise?
  6. How long can I expect to stay in the hospital after the surgery?
  7. What is the expected recovery process and timeline following a pericardiectomy?
  8. What symptoms should I watch for after the surgery that may indicate a complication?
  9. Will I need any follow-up appointments or tests after the surgery to monitor my recovery?
  10. Are there any lifestyle changes or medications I should consider after a pericardiectomy to reduce the risk of complications?

Reference

Authors: Huang JB, Wen ZK, Yang JR, Li JJ, Li M, Lu CC, Liang DY, Wei CX. Journal: J Cardiothorac Surg. 2022 Sep 30;17(1):244. doi: 10.1186/s13019-022-02007-1. PMID: 36180913