Perikardektomie und akute infektiose Perikarditis. [Pericardectomy and acute infectious pericarditis]
Détails
ID Serval
serval:BIB_A89A37AD8C4C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Perikardektomie und akute infektiose Perikarditis. [Pericardectomy and acute infectious pericarditis]
Périodique
Schweizerische Medizinische Wochenschrift
ISSN
0036-7672
Statut éditorial
Publié
Date de publication
02/1992
Peer-reviewed
Oui
Volume
122
Numéro
5
Pages
158-60
Notes
English Abstract
Journal Article --- Old month value: Feb 1
Journal Article --- Old month value: Feb 1
Résumé
Between 1980 and 1990 12 patients (5 male, 7 female) were operated on for acute infectious pericarditis at a mean age of 42 years. The infections were 6 bacterial (purulent 4, abscess 2), 4 tuberculous, 1 viral and 1 Candida. Pericarditis resulted from contiguous spread of infection from bilateral pneumonia in 3 patients, from subphrenic abscess in 2 and followed bacteremia in 1. Clinical signs were: tamponade/shock in 9, elevated jugular venous pressure in 11, edema in 6, hepatomegaly in 6, ascites in 1, and pericardial friction rub in 3. A preoperative pericardiocentesis in 9 patients allowed only 4 positive microbiological diagnoses and was an insufficient drainage in all cases. The preoperative mean NYHA class was 3.3. The pericardectomy was total in 9 patients and partial in 3. Total mortality was 1/12 patients (8%) with one late death due to recurrent tuberculous pericarditis. No patient with purulent pericarditis died. Another recurrence occurred 6 months after acute viral pericarditis. Atrial fibrillation in one patient was the only postoperative complication. After a mean follow-up period of 48.5 months no cardiac constriction had occurred in 11 surviving patients Actuarial survival after pericardectomy is 100% after 1 month and remains 91% after 5 years. The mean NYHA class has significantly improved to 1.2 (p less than 0.05) at the end of the follow-up. We conclude that pericardectomy combined with a specific antimicrobial therapy is a safe treatment for acute infectious and especially purulent pericarditis with low mortality and excellent longterm results. Early pericardectomy allows rapid decompression of the heart, removal of intrapericardial adhesions and infected tissue and prevents late constriction.(ABSTRACT TRUNCATED AT 250 WORDS)
Mots-clé
Acute Disease
Adolescent
Adult
Aged
Cardiac Tamponade/etiology
Child
Child, Preschool
Female
Humans
Male
Middle Aged
*Pericardiectomy
Pericarditis/complications/*surgery
Pericarditis, Tuberculous/surgery
Recurrence
Pubmed
Web of science
Création de la notice
14/02/2008 15:16
Dernière modification de la notice
20/08/2019 16:13