Long-term Survival after Pericardiectomy in Chronic Constrictive Pericarditis at Central Chest Institute of Thailand (CCIT)

Abstract

Background: Constrictive pericarditis is a rare and disabling disease. This study was to evaluate our single-center experience with pericardiectomy for chronic constrictive pericarditis.

Objective: The main objectives of our analysis were long-term survival, clinical outcome, mortality rate and identification of risk factors.

Method: A retrospective study of our database identified 45 patients who underwent pericardiectomy at Central Chest Institute of Thailand from January 1999 to January 2019. Demographic data, intraoperative and long term outcomes were analyzed.

Results: There were 39 men, with a mean age of 42.8 ± 15.1 years. Most presented with shortness of breath (87%), pitting edema (80 %), hepatomegaly (56%) or ascites (53%). Most common etiology of constrictive pericarditis was tuberculosis in 36 (80%) patients. Most of the patients (87%) were in New York Heart Association (NYHA) class II and III. The surgical approach was achieved via a median sternotomy in 43 (95.6%) patients. The hospital mortality was 13% in this study. The high preoperative NYHA and the high dose of inotropic drug in postoperative period were associated with a significantly higher hospital mortality. The survival rates were 90.8%, 76.8% and 63% at 1, 5 and 10 years, respectively.

Conclusion: Pericardiectomy was associated with a high morbidity and mortality rate. Nevertheless, it is able to improve the functional class and has a good long-term survival rate when compare with other studies. Preoperative functional class and high dose inotropic drug use are crucial in predicting the risk of hospital mortality.