Clinical Response To Pericardiectomy At UNTH, Enugu Nigeria

Abstract

Objective: Pericardiectomy as a means of surgical treatment is a standard procedure to improve the quality of life for patients with features of cardiac restriction. The aim of the study was to review the clinical response to pericardiectomy. Methods: A retrospective study of patients who had pericardiectomy between May 1995 and April 2000 was done. Records of relevant clinical features of the disorder necessitating pericardiectomy; diagnostic and prognostic investigations conducted were extracted from the case records. Results: A total of 36 patients were identified in the register as having had pericardiectomy in the period of review but only 21 (58.3%) case records were found. The clinical features noted were mainly of shortness of breath, abdominal, facial and feet swelling, ascites, low pulse pressure and tender hepatomegaly. There were pericardial effusion in 12(57%) and constrictive pericarditis 9 (42.9%) of the patients respectively. Sixteen patients (76.2%) had left anterolateral thoracotomy approach while 5 patients (23.8%) had sternotomy approach. Operative findings included thickened pericardium with or without effusion, pyopericardium, haemopericardium and calcified pericardium. Four months post surgery 14 patients (66.7%) had good clinical response while 4 patients (19%) had not responded favorably. Five patients (23.8%) were lost to follow-up after discharge. Conclusion: Pericardiectomy is beneficial to patients who have constrictive pericarditis. Poverty is alimitation to uptake of pericardiectomy. Key Words: Constrictive Pericarditis; Pericardiectomy; Clinical Response Orient Journal of Medicine Vol.16(1) 2004: 4-7