Shinya Unai1, Douglas R Johnston2. 1. Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Avenue/Desk J4-1, Cleveland, OH, 44195, USA. 2. Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Avenue/Desk J4-1, Cleveland, OH, 44195, USA. johnstd3@ccf.org.
Abstract
PURPOSE OF REVIEW: The surgical management of constrictive pericarditis has evolved from a partial pericardiectomy via a thoracotomy approach to a more extensive removal of the pericardium. This review summarizes the published studies regarding surgical management of pericardial disease, focusing on the surgical technique of radical pericardiectomy for constrictive pericarditis. RECENT FINDINGS: Anterior phrenic to phrenic resection without the use of cardiopulmonary bypass has been performed in many centers. This approach achieves improvement in symptoms; however, there are patients who have progressive constriction of the remaining pericardium requiring a completion pericardiectomy. Recent studies show that the survival and functional outcome is superior after a complete pericardiectomy. Our approach is to perform a complete pericardiectomy using cardiopulmonary bypass. In experienced centers, the outcomes have significantly improved with careful selection of patients, advances in pre- and postoperative care, and refinement in surgical techniques.
PURPOSE OF REVIEW: The surgical management of constrictive pericarditis has evolved from a partial pericardiectomy via a thoracotomy approach to a more extensive removal of the pericardium. This review summarizes the published studies regarding surgical management of pericardial disease, focusing on the surgical technique of radical pericardiectomy for constrictive pericarditis. RECENT FINDINGS: Anterior phrenic to phrenic resection without the use of cardiopulmonary bypass has been performed in many centers. This approach achieves improvement in symptoms; however, there are patients who have progressive constriction of the remaining pericardium requiring a completion pericardiectomy. Recent studies show that the survival and functional outcome is superior after a complete pericardiectomy. Our approach is to perform a complete pericardiectomy using cardiopulmonary bypass. In experienced centers, the outcomes have significantly improved with careful selection of patients, advances in pre- and postoperative care, and refinement in surgical techniques.
Authors: Leopold Rupprecht; Christina Putz; Bernhard Flörchinger; York Zausig; Daniele Camboni; Bernhard Unsöld; Christof Schmid Journal: Thorac Cardiovasc Surg Date: 2017-08-06 Impact factor: 1.827
Authors: P Nataf; P Cacoub; R Dorent; F Jault; V Bors; A Pavie; C Cabrol; I Gandjbakhch Journal: Eur J Cardiothorac Surg Date: 1993 Impact factor: 4.191
Authors: Arthur K Mutyaba; Sarvesh Balkaran; Robert Cloete; Naude du Plessis; Motasim Badri; Johan Brink; Bongani M Mayosi Journal: J Thorac Cardiovasc Surg Date: 2014-08-04 Impact factor: 5.209
Authors: Masud H Khandaker; Hartzell V Schaff; Kevin L Greason; Nandan S Anavekar; Raul E Espinosa; Sharonne N Hayes; Rick A Nishimura; Jae K Oh Journal: Mayo Clin Proc Date: 2012-11 Impact factor: 7.616
Authors: Hassan Mehmood Lak; Chris M Anthony; Muhammad M Furqan; Beni Rai Verma; Mohamed Gad; Sanchit Chawla; Farah Yasmin; Deborah H Kwon; Douglas R Johnston; Allan L Klein Journal: JACC Case Rep Date: 2021-12-01