Futility of pericardiectomy for postirradiation constrictive pericarditis?

Détails

ID Serval
serval:BIB_0E91550F7E18
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Futility of pericardiectomy for postirradiation constrictive pericarditis?
Périodique
Annals of Thoracic Surgery
Auteur(s)
Ni  Y., von Segesser  L. K., Turina  M.
ISSN
0003-4975
Statut éditorial
Publié
Date de publication
03/1990
Peer-reviewed
Oui
Volume
49
Numéro
3
Pages
445-448
Notes
Case Reports Journal Article Review --- Old month value: Mar
Résumé
Two patients underwent pericardiectomy for postirradiation constrictive pericarditis. Both had received radiotherapy (more than 6,000 rads) for treatment of Hodgkin's disease 17 (patient 2) and 20 years (patient 1) earlier. At the time of operation, the patients were in New York Heart Association functional class III-IV or IV. Preoperative catheterization showed the following pressures for patients 1 and 2, respectively: right atrial, 30 and 14 mm Hg; right ventricular end-diastolic, 28 and 14 mm Hg; wedge, 29 and 13 mm Hg; and left ventricular end-diastolic, 27 and 14 mm Hg. Complete epicardiectomy and pericardiectomy was attempted in both patients. However, hospital mortality was 100%; patient 1 died of multiorgan failure after six days, and patient 2 died of biventricular failure after 3 months. A review of the literature revealed 44 cases of pericardiectomy for postirradiation constrictive pericarditis and a late survival rate of less than 50%. The poor results in these patients compared with patients having pericardiectomy for other reasons seem to be due mainly to the various kinds of radiation-induced damage to the heart as a whole, including untimely coronary artery disease, myocardial fibrosis, atrioventricular conduction disturbances, and valve dysfunction, with the result that complete relief by epicardiectomy and pericardiectomy may not be technically feasible.
Mots-clé
Adult Fibrosis Heart/radiation effects Hodgkin Disease/radiotherapy Humans Male Mediastinal Neoplasms/radiotherapy *Pericardiectomy Pericarditis, Constrictive/etiology/*surgery Pericardium/radiation effects Radiation Injuries/*surgery
Pubmed
Web of science
Création de la notice
14/02/2008 14:15
Dernière modification de la notice
20/08/2019 12:35
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