Our Summary

This paper reviews the current methods of treating diseases of the pericardium, a sac-like structure that encloses the heart. Since the pericardium doesn’t often require surgery, there aren’t any widely agreed-upon guidelines for how to treat it surgically. The way doctors and hospitals approach this kind of surgery has changed slowly over time and varies a lot, mainly because the procedure is considered quite risky. The study focuses on how the reasons for pericardiectomy (removal of the pericardium) have changed, how it’s now being used to treat inflammatory or recurring pericarditis (inflammation of the pericardium), and how surgical techniques and planning have improved. These improvements have led to better patient results in hospitals with more experience in this kind of surgery.

FAQs

  1. What is the pericardium and why might it require surgery?
  2. What are the current methods of treating diseases of the pericardium?
  3. How have the reasons for performing a pericardiectomy changed over time?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about pericardiectomy is to choose a hospital and surgeon with experience in performing this procedure. It is important to research and find a healthcare provider who has a good track record with pericardiectomy surgeries, as this can greatly impact the outcome and recovery process. Additionally, following post-operative care instructions and attending follow-up appointments are crucial for a successful recovery.

Suitable For

Patients who are typically recommended for pericardiectomy are those with severe or recurrent pericarditis that does not respond to conservative medical treatments such as medication. These patients may experience symptoms such as chest pain, shortness of breath, and fluid buildup around the heart. Pericardiectomy may also be recommended for patients with constrictive pericarditis, a condition where the pericardium becomes thickened and stiff, leading to impaired heart function.

Additionally, patients with tumors or other abnormalities of the pericardium may also be candidates for pericardiectomy. It is important for patients to be evaluated by a multidisciplinary team of healthcare providers to determine if pericardiectomy is the most appropriate treatment option for their specific condition.

Timeline

Before pericardiectomy:

  • Patient presents with symptoms such as chest pain, shortness of breath, and fatigue
  • Diagnostic tests such as echocardiogram, MRI, and CT scan are performed to confirm pericardial disease
  • Patient may undergo non-surgical treatments such as medications or pericardiocentesis (draining of fluid from the pericardium) to manage symptoms

After pericardiectomy:

  • Surgery is performed to remove part or all of the pericardium
  • Patient is closely monitored in the intensive care unit post-surgery
  • Recovery period may involve pain management, physical therapy, and monitoring for complications such as infection or bleeding
  • Patient may experience improved symptoms such as decreased chest pain and improved cardiac function
  • Follow-up appointments are scheduled to monitor long-term outcomes and adjust treatment as needed.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pericardiectomy?
  2. How experienced is the surgical team in performing pericardiectomies?
  3. What is the success rate of pericardiectomy in treating inflammatory or recurring pericarditis?
  4. What is the recovery process like after undergoing a pericardiectomy?
  5. Are there any alternative treatment options to consider before deciding on a pericardiectomy?
  6. How long will I need to stay in the hospital after the surgery?
  7. What kind of follow-up care will be needed after the procedure?
  8. Are there any lifestyle changes or restrictions I should be aware of post-surgery?
  9. How will my heart function be affected by the removal of the pericardium?
  10. What is the long-term outlook for patients who undergo a pericardiectomy?

Reference

Authors: Johnston DR. Journal: Prog Cardiovasc Dis. 2017 Jan-Feb;59(4):407-416. doi: 10.1016/j.pcad.2017.01.005. PMID: 28214508