Chirurgie der infektiosen Perikarditis. [Surgery of infectious pericarditis]

Details

Serval ID
serval:BIB_01F0742304B6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Chirurgie der infektiosen Perikarditis. [Surgery of infectious pericarditis]
Journal
Helvetica Chirurgica Acta
Author(s)
Niederhauser  U., von Segesser  L. K., Carrel  T., Laske  A., Bauer  E., Schonbeck  M., Turina  M.
ISSN
0018-0181
Publication state
Published
Issued date
01/1992
Volume
58
Number
4
Pages
559-63
Notes
English Abstract
Journal Article --- Old month value: Jan
Abstract
Between 1980 and 1990 34 patients (pat.) (21 male, 13 female) were operated for infectious pericarditis (P.) at a mean age of 48 years (min. 2, max. 70 years). The infection was acute in 12 pat. (7 bacterial, 4 Tbc, 1 viral). A chronic constrictive P. was found in 22 pat. (15 history of Tbc, 7 history of viral P.). The preoperative mean NYHA class was 3.0. Cardiac catheterization was performed in 22 pat. and confirmed restrictive pericardial disease in all cases with elevated and equalized diastolic pressures in all 4 cardiac chambers. Mean cardiac index was 2.7 l/min m2 and the ejection fraction 53%. Pericardectomy (Pe.) was performed through an anterolateral left thoracotomy in 31 pat. and through a sternotomy in 3 pat. Total and partial Pe. were performed in 31 and 3 pat., respectively. Total mortality was 3/34 pat. (8.8%) with no operative death (one early and two late deaths). There were two recurrent P. (1 Tbc, 1 viral) and no recurrent constriction. Long-time follow-up of 31 surviving pat. is known in 28 cases with a mean follow-up of 4.6 years (min. 1 month, max 10.5 years). At the end of the follow-up the mean NYHA class ist 1.3 (p less than 0.005). Actuarial survival after Pe. is 97% after 30 days and 90% after 5 and 10 years. In our retrospective study we conclude that Pe. is a safe treatment for infectious P. with low mortality and excellent long-time results with improvement of cardiac function. Pe. should be performed early for purulent or constrictive P. There is no conservative treatment for progressive myocardial constriction and the resulting cardiomyopathy. After total Pe. there is a low rate of recurrent P. or constriction.
Keywords
Adolescent Adult Aged Child Child, Preschool Female Humans Male Middle Aged Pericardiectomy Pericarditis/mortality/*surgery Pericarditis, Constrictive/mortality/surgery Pericarditis, Tuberculous/mortality/surgery Postoperative Complications/*mortality Recurrence Reoperation Survival Rate
Pubmed
Web of science
Create date
14/02/2008 14:17
Last modification date
20/08/2019 12:24
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