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The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis

BACKGROUND: The aim of this study was to analyze the preoperative attributes and clinical impacts of complete pericardiectomy in chronic constrictive pericarditis. METHODS: A total of 26 patients were treated from January 2001 to December 2013. The pericardium was resected as widely as possible. Whe...

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Autores principales: Kim, Sang Yoon, Na, Kwon Joong, Kim, Kyung-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Thoracic and Cardiovascular Surgery 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295479/
https://www.ncbi.nlm.nih.gov/pubmed/28180099
http://dx.doi.org/10.5090/kjtcs.2017.50.1.22
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author Kim, Sang Yoon
Na, Kwon Joong
Kim, Kyung-Hwan
author_facet Kim, Sang Yoon
Na, Kwon Joong
Kim, Kyung-Hwan
author_sort Kim, Sang Yoon
collection PubMed
description BACKGROUND: The aim of this study was to analyze the preoperative attributes and clinical impacts of complete pericardiectomy in chronic constrictive pericarditis. METHODS: A total of 26 patients were treated from January 2001 to December 2013. The pericardium was resected as widely as possible. When excessive bleeding or hemodynamic instability occurred intraoperatively, a cardiopulmonary bypass (CPB; n=3, 11.5%) or an apical suction device (n=8, 30.8%) was used. Patients were divided into 2 groups: those who underwent ≥ 80% resection of the pericardium (group A, n=18) and those who underwent <80% resection of the pericardium (group B, n=8). RESULTS: The frequency of CPB use was not significantly different between groups A and B (n=2, 11.1% vs. n=1, 12.5%; p=1.000). However, the apical suction device was more frequently applied in group A than group B (n=8, 30.8% vs. n=0, 0.0%; p=0.031). The postoperative New York Heart Association functional classification improved more in group A (p=0.030). Long-term follow-up echocardiography also showed a lower frequency of unresolved constriction in group A than in group B (n=1, 5.60% vs. n=5, 62.5%; p=0.008). CONCLUSION: Patients with chronic constrictive pericarditis demonstrated symptomatic improvement through complete pericardiectomy. Aggressive resection of the pericardium may correct constrictive physiology and an apical suction device can facilitate the approach to the posterolateral aspect of the left ventricle and atrioventricular groove area without the aid of CPB.
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spelling pubmed-52954792017-02-08 The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis Kim, Sang Yoon Na, Kwon Joong Kim, Kyung-Hwan Korean J Thorac Cardiovasc Surg Clinical Research BACKGROUND: The aim of this study was to analyze the preoperative attributes and clinical impacts of complete pericardiectomy in chronic constrictive pericarditis. METHODS: A total of 26 patients were treated from January 2001 to December 2013. The pericardium was resected as widely as possible. When excessive bleeding or hemodynamic instability occurred intraoperatively, a cardiopulmonary bypass (CPB; n=3, 11.5%) or an apical suction device (n=8, 30.8%) was used. Patients were divided into 2 groups: those who underwent ≥ 80% resection of the pericardium (group A, n=18) and those who underwent <80% resection of the pericardium (group B, n=8). RESULTS: The frequency of CPB use was not significantly different between groups A and B (n=2, 11.1% vs. n=1, 12.5%; p=1.000). However, the apical suction device was more frequently applied in group A than group B (n=8, 30.8% vs. n=0, 0.0%; p=0.031). The postoperative New York Heart Association functional classification improved more in group A (p=0.030). Long-term follow-up echocardiography also showed a lower frequency of unresolved constriction in group A than in group B (n=1, 5.60% vs. n=5, 62.5%; p=0.008). CONCLUSION: Patients with chronic constrictive pericarditis demonstrated symptomatic improvement through complete pericardiectomy. Aggressive resection of the pericardium may correct constrictive physiology and an apical suction device can facilitate the approach to the posterolateral aspect of the left ventricle and atrioventricular groove area without the aid of CPB. The Korean Society for Thoracic and Cardiovascular Surgery 2017-02 2017-02-05 /pmc/articles/PMC5295479/ /pubmed/28180099 http://dx.doi.org/10.5090/kjtcs.2017.50.1.22 Text en Copyright © 2017 by The Korean Society for Thoracic and Cardiovascular Surgery. All rights Reserved. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research
Kim, Sang Yoon
Na, Kwon Joong
Kim, Kyung-Hwan
The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis
title The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis
title_full The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis
title_fullStr The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis
title_full_unstemmed The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis
title_short The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis
title_sort importance of complete pericardiectomy and the role of the apical suction device in chronic constrictive pericarditis
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295479/
https://www.ncbi.nlm.nih.gov/pubmed/28180099
http://dx.doi.org/10.5090/kjtcs.2017.50.1.22
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