Our Summary

This study looked at the effectiveness of a specific treatment for a chronic heart condition known as constrictive pericarditis, which often requires surgery. The treatment involves a procedure called radical pericardiectomy and the use of a heart-lung machine (cardiopulmonary bypass, or CPB) and a device that suctions the tip of the heart (apical suction device).

The researchers reviewed the medical records of 10 patients who underwent this treatment. They collected information about their health, the details of the surgery, and the patients’ health after the surgery. They also checked on the patients’ heart function and symptoms 3 months after the procedure and followed up on their survival for an average of about 31 months.

They found that 60% of the patients needed the heart-lung machine during surgery. Even though these patients took longer to recover and had to stay in the hospital for longer periods, using the heart-lung machine did not lead to more complications after surgery. They also found that 3 months after the procedure, the patients’ heart function had significantly improved and their symptoms were relieved. Importantly, none of the patients had a recurrence of the heart condition during the follow-up period.

In conclusion, the treatment appears to be effective in managing this heart condition, with promising short-term results and low rates of recurrence. However, more research with more patients and longer follow-up periods is needed to confirm these findings.

FAQs

  1. What is the standard treatment for constrictive pericarditis (CP)?
  2. What is the purpose of using cardiopulmonary bypass (CPB) in the treatment of CP?
  3. What were the results of the study on the effectiveness of radical pericardiectomy combined with CPB and the apical suction device in treating CP?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to follow postoperative recovery instructions closely, including taking prescribed medications, attending follow-up appointments, and gradually increasing activity levels as advised by the healthcare team. It is important to communicate any concerns or changes in symptoms to the medical team promptly to ensure optimal recovery and long-term success of the surgery.

Suitable For

Patients with constrictive pericarditis (CP) who have failed medical management and are experiencing symptoms such as shortness of breath, fatigue, and edema are typically recommended for pericardiectomy. Patients with evidence of hemodynamic compromise, such as signs of right heart failure or elevated filling pressures, may also benefit from surgical intervention. Additionally, patients with evidence of pericardial thickening or calcification on imaging studies may be candidates for pericardiectomy. It is important for patients to undergo a thorough evaluation by a multidisciplinary team, including cardiologists and cardiac surgeons, to determine the most appropriate treatment approach for their specific condition.

Timeline

  • Before pericardiectomy: The patient likely experiences symptoms of constrictive pericarditis, such as shortness of breath, chest pain, fatigue, and swelling in the legs. They may have undergone diagnostic tests such as echocardiograms or cardiac MRI to confirm the diagnosis. Surgery is recommended when conservative treatments are not effective in managing the symptoms.

  • During pericardiectomy: The patient undergoes radical pericardiectomy, which involves removing the constricting pericardium. In some cases, cardiopulmonary bypass (CPB) is used during surgery to support the patient’s circulation. The apical suction device may also be utilized to aid in the surgical procedure. The surgery typically requires a hospital stay and a period of recovery.

  • After pericardiectomy: The patient experiences improvements in cardiac function and symptom relief in the weeks and months following surgery. Follow-up assessments, including echocardiograms and clinical evaluations, are performed at 3 months post-surgery. The patient’s recovery time and hospital stay may be longer if CPB was used during the surgery, but there is no increase in postoperative complications. The patient is monitored for any signs of recurrence of constrictive pericarditis during follow-up appointments. Overall, radical pericardiectomy combined with CPB and the apical suction device is shown to be effective in treating CP, with favorable short-term outcomes and low recurrence rates. Further studies with larger sample sizes and longer follow-up durations are needed to confirm these findings.

What to Ask Your Doctor

  1. What is the purpose of a pericardiectomy in treating constrictive pericarditis?

  2. Do I need to undergo cardiopulmonary bypass during the surgery? What are the risks and benefits associated with using CPB?

  3. What is the success rate of radical pericardiectomy combined with CPB in treating CP?

  4. What are the potential complications or risks associated with this surgical procedure?

  5. How long is the recovery period after undergoing a pericardiectomy?

  6. Will I need any follow-up evaluations or tests after the surgery?

  7. Are there any specific lifestyle changes or medications that I will need to take after the procedure?

  8. What is the likelihood of recurrence of constrictive pericarditis after undergoing a pericardiectomy?

  9. Are there any alternative treatment options for constrictive pericarditis that I should consider?

  10. How long is the expected survival rate after undergoing a pericardiectomy for constrictive pericarditis?

Reference

Authors: Thuan PQ, Han TQ, Thang HD, Dinh NH. Journal: Glob Cardiol Sci Pract. 2024 Nov 1;2024(5):e202445. doi: 10.21542/gcsp.2024.45. eCollection 2024 Nov 1. PMID: 39931447