Topic
Pericardiectomy
About: Pericardiectomy is a research topic. Over the lifetime, 1491 publications have been published within this topic receiving 24043 citations.
Papers published on a yearly basis
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Papers
TL;DR: The evolving profile of CP, with increasingly older patients and those with radiation-induced disease in the past decade, significantly affects postoperative prognosis, and long-term results of pericardiectomy are disappointing for some patient groups, especially those with Radiation-induced CP.
Abstract: Background —The clinical spectrum of constrictive pericarditis (CP) has been affected by a change in incidence of etiological factors. We sought to determine the impact of these changes on the outcome of pericardiectomy. Methods and Results —The contemporary spectrum of CP in 135 patients (76% male) evaluated at the Mayo Clinic from 1985 to 1995 was compared with that of a historic cohort. Notable trends were an increasing frequency of CP due to cardiac surgery and mediastinal radiation and presentation in older patients (median age, 61 versus 45 years). Perioperative mortality decreased (6% versus 14%, P =0.011), but late survival was inferior to that of an age- and sex-matched US population (57±8% at 10 years). The long-term outcome was predicted independently by 3 variables in stepwise logistic regression analyses: (1) age, (2) NYHA class, and most powerfully, (3) a postradiation cause. Of 90 late survivors in whom functional class could be determined, functional status had improved markedly (2.6±0.7 at baseline versus 1.5±0.8 at latest follow-up [ P Conclusions —The evolving profile of CP, with increasingly older patients and those with radiation-induced disease in the past decade, significantly affects postoperative prognosis. Long-term results of pericardiectomy are disappointing for some patient groups, especially those with radiation-induced CP. By contrast, surgery alleviates or improves symptoms in the majority of late survivors.
609 citations
TL;DR: Long-term survival after pericardiectomy for CP is related to underlying etiology, LV systolic function, renal function, kidney function, serum sodium, and PAP, and the relatively good survival with idiopathic CP emphasizes the safety of pericardectomy in this subgroup.
469 citations
TL;DR: Although baseline hemodynamics in the two groups were similar, characteristic changes were seen with respiration that suggest differentiation of these disease states may also be possible from hemodynamic data.
Abstract: Doppler ultrasound recordings of mitral, tricuspid, aortic, and pulmonary flow velocities, and their variation with respiration, were recorded in 12 patients with a restrictive cardiomyopathy and seven patients with constrictive pericarditis. Twenty healthy adults served as controls. The patients with constrictive pericarditis showed marked changes in left ventricular isovolumic relaxation time and in early mitral and tricuspid flow velocities at the onset of inspiration and expiration. These changes disappeared after pericardiectomy and were not seen in patients with restrictive cardiomyopathy or in normal subjects. The deceleration time of early mitral and tricuspid flow velocity was shorter than normal in both groups, indicating an early cessation of ventricular filling, but only patients with restrictive cardiomyopathy showed a further shortening of the tricuspid deceleration time with inspiration. Diastolic mitral and tricuspid regurgitation was also more common in the patients with restrictive cardiomyopathy. These results suggest that patients with constrictive pericarditis and restrictive cardiomyopathy can be differentiated by comparing respiratory changes in transvalvular flow velocities. In addition, although baseline hemodynamics in the two groups were similar, characteristic changes were seen with respiration that suggest differentiation of these disease states may also be possible from hemodynamic data.
432 citations
TL;DR: When clinical, echocardiographic, or invasive hemodynamic features indicate constriction in patients with heart failure, pericardiectomy should not be denied on the basis of normal thickness as demonstrated by noninvasive imaging.
Abstract: Background— Traditionally, increased pericardial thickness has been considered an essential diagnostic feature of constrictive pericarditis. Although constriction with a normal-thickness pericardium has been demonstrated clinically by noninvasive imaging, the details of clinicopathological correlates have not been described. Methods and Results— A total of 143 patients with proven constriction underwent pericardiectomy at Mayo Clinic between 1993 and 1999. Their baseline characteristics, operative data, and pathological specimens were reviewed retrospectively. The pericardium was of normal thickness (≤2 mm) in 26 patients (18%; group 1) and was thickened (>2 mm) in 117 (82%; group 2). The most common causes of constriction in group 1 included previous cardiac surgery, chest irradiation, previous infarction, and idiopathic disease. There was little difference in symptoms and findings on physical examination between the 2 groups. Microscopically, no patient had an entirely normal pericardium. Histopathologi...
429 citations
TL;DR: The management of pericardial diseases is largely empirical because of the relative lack of randomized trials, and a major controversy in “pericardiology” is the role of an extensive etiologic search and hospital admission for all patients withPericarditis or pericARDial effusion.
Abstract: The management of pericardial diseases is largely empirical because of the relative lack of randomized trials. The first published guidelines1,2 are a first attempt to organize current knowledge. At present, no specific guidelines have been issued by the American Heart Association and American College of Cardiology. After a literature review including a Medline search with the MeSH terms “pericarditis” and “pericardium,” we identified the following controversial issues related mainly to the management of pericarditis and pericardial effusion: (1) etiological search and hospitalization; (2) role of pericardiocentesis, pericardial biopsy, and pericardioscopy; (3) myopericarditis; (4) use of corticosteroids, nonsteroidal antiinflammatory drugs (NSAIDs), and colchicine; (5) management of refractory cases and long-term outcome; (6) role of pericardiectomy, pericardial window, and other interventional techniques; and (7) management of chronic idiopathic pericardial effusion.
At the end of each issue, key points are summarized. Management of most cases is done by general practitioners or different healthcare specialists and does not require specific expertise; nevertheless, incessant and recurrent cases and specific forms (eg, tuberculous pericarditis, neoplastic pericardial disease, autoimmune conditions) require cooperation among specialties (eg, cardiology, infectious diseases, rheumatology, oncology). Specific interventional techniques (eg, pericardioscopy) and pericardiectomy should be performed in referral centers.
### Pericarditis
Although the clinical diagnosis of pericarditis is relatively simple (Tables 1 and 2⇓),1–13 establishing the cause may be more difficult. A major controversy in “pericardiology” is the role of an extensive etiologic search and hospital admission for all patients with pericarditis or pericardial effusion.1–8 The causes of pericarditis are varied (Table 3),9 and the clinician should identify causes that require targeted therapies. The epidemiological background is essential to develop a rational cost-effective management program3,4,15,16; the approach may be different for research, when we attempt to reduce the number of “idiopathic” cases. In developed countries, idiopathic …
402 citations
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Performance Metrics
| Year | Papers |
|---|---|
| 2025 | 18 |
| 2024 | 29 |
| 2023 | 77 |
| 2022 | 89 |
| 2021 | 65 |
| 2020 | 64 |