Détail de la notice
Titre du Document
Pericardiectomy for constrictive pericarditis : A clinical, echocardiographic, and hemodynamic evaluation of two surgical techniques
Auteur(s)
CHOWDHURY Ujjwal K. ; SUBRAMANIAM Ganapathy K. ; SAMPATH KUMAR A. ; ...
Résumé
Background. This study was designed to compare the outcomes after total versus partial pericardiectomy clinically, echocardiographically, and hemodynamically. Methods. Three hundred ninety-five patients undergoing pericardiectomy for constrictive pericarditis between January 1985 and December 2004 were studied. Age was 10 months to 71 years (mean, 25.1 ± 13.4 years). Three hundred thirty-eight patients (85.6%) underwent total pericardiectomy (group I), and 57 patients (14.4%) underwent partial pericardiectomy (group II). Results. Operative and late mortality rates were 7.6% and 4.9%, respectively. Preoperative high right atrial pressure, hyperbilirubinemia, renal dysfunction, atrial fibrillation, pericardial calcification, thoracotomy approach, and partial pericardiectomy were significant risk factors for death. The risk of death was 4.5 times higher (95% confidence interval: 2.05 to 9.75) in patients undergoing partial pericardiectomy. At a mean follow-up of 17.9 ± 0.3 years (95% confidence interval: 17.3 to 18.6), actuarial survival was 83.8% ± 0.04% in group I and 73.9% ± 0.06% in group II (p = 0.004). At their last follow-up, 96.3% survivors of group I and 79.1% survivors of group II were in New York Heart Association class I/II (p < 0.001). Conclusions. Total pericardiectomy is associated with lower perioperative and late mortality, and confers significant long-term advangage by providing superior hemodynamics that appear to be independent of the etiology of constric
Editeur
Elsevier Science
Identifiant
ISSN : 0003-4975 CODEN : ATHSAK
Source
The Annals of thoracic surgery A. 2006, vol. 81, n° 2, pp. 522-530 [9 pages] [bibl. : 15 ref.]
Langue
Anglais
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